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I 



Rbobivbd in Exchahob 
Lafay«tt« Coll«gfl 

n:i.nTn:xf:rrmi!f'f.''^jir. 



1 



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Mr 



1 



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y. 



Medical Society 



OF 



NEW JERSEY. 



TKAN8AOTIONS, 1884. 



The next Annual Meeting of the MEDICAL SOCIETY 
OF NEW JERSEY, will be held at Long Branch, on the 
second Tuesday of June, 1885, at four, P. M. 

Each District Society is entitled to three Delegates at 
large and one additional for every ten members. 

The District Reporters are requested to send their reports 
to the Chairman of the Standing Committee by the 15th of 
May. 

The assessment for the year 1884 upon the * District 
Societies is One Dollar and Fiftj^ Cents for each member. 

The Secretaries of the respective Societies are requested 
to send a list of Delegates and Members to the Recording 
Secretary, at Orange, on or before the first Tuesday of 
June, 1885. 



TRANSACTIONS 



OF THE 



Medical Society 



OF 



NEW JERSEY. 



J * - - • 

5 « J • • 

» • 



1884. 



L. y. Hardham, Printer, 243 &=■ 245 Market Street, Newark. N. y. 

1884. 



OFFICERS, 1884. 

> ♦ » 

PRESIDENT, 
P. C. BARKER, MoRRiSTOWN. 

VICE-PRESIDENTS, 

ist. JOSEPH PARRISH, - - - Burlington. 
2d. CHARLES J. KIPP, - - - - Newark. 

3d. JOHN W. WARD, Trenton. 

CORRESPONDING SECRETARY, 
WM. ELMER, Jr., Trenton. 

RECORDING SECRETARY, 
WM. PIERSON, - . ; - . - - . Orange. 

• » w C 

TREASURER, 
W. W. L. PHILLIPS, Trenton. 

STANDING COMMITTEE. 

T. J. SMITH, Chairman, . _ - _ Bridgeton. 

E. J. MARSH, Paterson. 

D. C. ENGLISH, . . - . New Brunswick. 



VJ- 




r . 


1 



FELLOWS. 



All persons who shall have been, or may hereafter be President of the Society, shall rank as 
Fellows, and be entitled to all the privileges of delegated members. 

Act of Incorporation. Sec. i. 
The dates represent the year of official service as President 
Those marked thus [*] are deceased. 



♦Charles Smith 

♦Matt. H.Williamson.. 

♦Samuel Forman 

♦John Van Cleve 

♦Lewis Dunham 

♦Peter I. Stryker 

♦John Van Cleve 



♦Robert McKean 1 766 

♦William Burnett. 1767 

♦John Cochran 1768 

♦Nathaniel Scudder 1770 

♦Isaac Smith 1771 

♦James Newell 1772 

♦Absalom Bainbridge . . . . i 773 

♦Thomas Wiggins 1774 ♦Lewis Condict 

♦Hezekiah Stites 1775 ♦James Lee 

♦♦♦♦♦♦ ♦William G. Reynolds.. 

♦John Beatty 1782 ♦Augustus R. Taylor. . . 

•♦Thomas Barber 1773 ♦William B. Ewing 

♦Lawrence Van DERVEER.1784 ♦Peter L Stryker. . 

♦Moses Bloomfield 1785 ^Gilbert S. Woodhull. . 

♦William Burnett 1786 ♦Wm. D. McKissack 

♦Jonathan Elmer 1787 ♦Isaac Pierson 

+JAMES Stratton 1 788 ♦Jeptha B. Munn 

♦iMosES Scott 1789 ♦John W. Craig 

♦John Griffith 1790 ♦Augustus R. Taylor. . . 

♦Lewis Dunham 1791 ♦Thomas Yarrow 

*ISAAC Harris 1792 

♦Elisha Newell 1795 

♦Jonathan F. Morris 1807 

♦Peter I. Stryker 1808 

♦Lewis Morgan 1809 



♦FiTz Randolph Smith. 

♦William Forman 

♦Samuel Hayes 

♦Abm. p. Hageman 

♦Henry Van Derveer. . 



♦Lewis Condict 1810 ♦Lyndon A. Smith 



811 
812 
814 

815 
816 

817 
818 
819 
820 
821 
822 
823 
824 
825 
826 
827 
828 
829 
830 

831 
832 

833 

834 

835 
836 

837 



MEDICAL SOCIETY OF NEW JERSEY. 



♦Benj. H. Stratton 

♦JABEZ G. GOBLE 

♦Thomas P. Stewart 

♦Ferdinand S. Schenck. . 

*Zachariah Read 

♦Abraham Skillman 

George R. Chetwood 

♦Robert S. Smith 

♦Charles Hannah 

♦Jacob T. B. Skillman 

Samuel H. Pennington.. 

♦Joseph Fithian 

♦Elias J. Marsh 

♦John H. Phillips 

♦Othn'l H. Taylor 

♦Samuel Lilly 

♦A. B. Dayton 

♦J. B. Coleman 

♦Richard M. Cooper 

Thomas Ryerson 

♦Isaac P. Coleman 

♦John R. Sickler 

Wm. Elmer 



838 JNO. Blane 1861 

839 jNO. WOOLVERTON 1 862 

840 Theo. R. Varick 1863 

841 Ezra M. Hunt 1864 

842 Abram Coles 1865 

843 ♦Benjamin R. Bateman. . 1866 

844 jNO. C. Johnson 1867 

845 ♦Thomas J. Corson 1868 

846 ♦Wm. Pierson 1869 

847 ♦Thomas F. Cullen 1870 

848 ♦Charles Hasbrouck.. .,1871 

849 Franklin Gauntt .1872 

850 ♦T. J. Thom ASON •. . . 1 873 

851 G. It. Larison 1874 

852 Wm. O'GoRMAN 1875 

853 ♦jNO. V. Schenck 1876 

854 Henry R. Baldwin 1877 

855 John S. Cook 1878 

856 Alex. W. Rogers 1879 

857 ♦Alex. N. Dougherty 1880 

858 Lewis W. Oakley 1881 

859 John W. Snowden 1882 

860 Stephen WiCKES .. ..1883 



HONORARY MEMBERS. 



^-^•^ 



♦David Hosack, New York 1827 

827 
830 

839 

839 

839 
842 

843 
848 

848 

848 

849 
850 
850 

853 
854 
861 
861 
867 
868 
872 
872 
872 
872 

874 
876 

880 
880 
884 
884 



*J. W. Francis 

♦John Condict, Orange 

♦Usher Parsons, Rhode Island 

♦Reuben D. Murphy, Cincinnati 

♦Alban G. Smith, New York 

♦WiLLARD Parker, New York . . 

♦Valentine Mott, New York 

♦Jonathan Knight, New Haven 

♦Nath'l Chapman, Philadelphia 

♦Alexander H. Stephens, New York. . . 

♦John C. Warren, Boston 

♦Lewis C. Beck, New York 

♦John C. Torrey, New York 

♦George B. Wood, Philadelphia 

H. a. Buttolph, Morris Plains, N. J 

Ashbel Woodward, Franklin, Conn 

♦Thomas W. Blatchford, Troy, N. Y . . 
♦Jeremiah S. English, Manalapan, N. J. 

Stephen Wickes, Orange, N.J 

S. O. Vanderpool, Albany, N. Y 

Jos. Parrish, Burlington, N. J 

Ferris Jacobs, Delhi, N. Y 

C. A. LiNDSLEY, New Haven, N. Y 

Wm. Pepper, Philadelphia 

S. Wier Mitchell, Philadelphia 

Cyrus F. Brackett, Princeton, N. J 

Joseph C. Hutchinson, Brooklyn, N. Y 

Thomas Addis Emmett, New York 

Isaac Taylor, New York 



Members of District Medical Societies! 



REPRESENTED AT THE 



ANNUAL MEETING, 1884. 



ATLANTIC COUNTY. 

(District Society organized June 7, x88o.) 



Edward North, Pres,^ Hammonton 

D. B. Ingersoll, V, P., Mays Vd'g 
T. H. Boysen, Secy, Egg Har. City 

E. H. Madden, Treas., Absecom 
Boardman Reed, Rep., Atlantic C, 
J. B. Somers, Linwood 
Willard Wright, Atlantic City 
Charles Gill, May's Landing 
L. H. Armstrong, Atlantic City 

No. Members, 17. 



Samuel C. Edmunds, Linwood 

S. A. S. Jessup, Atlantic City 

Rebecca Hallowell, 

H. H. Bennet, 

Charles Souders. 

William Pollard, 

J. J. Comfort, 

Joseph North, Pleasantville 

Theo. H. Boysen, Secretary. 



BERCEN COUNTY. 

(District Society reorganized February 38, 1854.) 



Milton Turnure, Pres,, Tenafly 
John W. Hopper, F. P,, Hackensk 
David St. John, Treas , " 

Dan'l A. Currie, Sec'y, Englewood 
J. M. Simpson,^^/., Schraalenb'gh 



M. S. Ayres, 
H. C. Neer, 
S. J. Zabriskie, 
Thomas Reid, 
Frederick Morris, 
H. A. Crarey, 

Abraham S. Burdett, Hackensack 
No. Members, 23. 



Fairview 

Park Ridge 

Westwood 

Norwood 

Closter 



Alex. Qendinen, 
J. T. De Mund, 
John J. Haring, 
George E. Brown, 
C. L. Demarest, 
Joseph Huger, 
J. W. Terry, 
Wm. H. P. Taylor, 
A. P. Williams, 
Isadore P. Latour, 
John W. Wells. 



Fort Lee 

Ridgewood 

Tenafly 

Hackensack 

Areola 

Fort Lee 

Englewood 

Ridgefield 

Carlstadt 

Fort Lee 

Engleivood 



Daniel A. Currie, Secretary. 



10 



MEDICAL SOCIETY OF NEW JERSEY. 
BURLINGTON COUNTY. 

(District Society organized May 19, 1829). 



Burlington 



Wm. P. Melcher, Pres., Mt. Holly J. Howard Pugh, 

Wm. L. Martin, V. P., Rancocas L. Van Rensselaer, ** 

A. W. Taylor, Secretary, Beverly Walter E. Hall, ** 

E.Hollingshead, Treas., Pemberton Edward S. Lansing, " 

S. C. Thornton, Rep,, Moorestown H. H. Longstreet, Bordentown 

Joseph Parrish, Hist., Burlington Lewis Jemison, 

Francis Ashurst, Censor ^ Mt. Holly Irene D. Young, 



tt 



it 



George Goodell, 



<( 



Sykesville Wm. H. Shipps, 



<« 



S. C. Thornton, " Moorestown 



Richard E. Brown, 
W. C. Parry, 
Wm. Chamberlain, 
Chas. Bispham, Jr., 
Richard H. Parsons, 
R. C. Barrington, 
Franklin Gauntt, 



Mf. Holly 



<• 



(( 



<• 



f< 



Burlington 



R. H. Page, 
D. G. Van Mater, 
Lewis L. Sharp, 
J. Reeve, 

N. Newlin Stokes, 
Alex. Elwell, 
Theo. T. Price, 
Alex. Marcy, Jr., 



Columbus 



(( 



Medford 



<< 



Moorestown 

Vincentown 

Tuckerton 

Riverton 



Charles Ellis, 



HONORARY MEMBERS. 

Burlington Chas. H. Thomas, 

1807 Chestnut St., Phila. 
No. Members, 32. A. W. Taylor, Secretary. 



CAMDEN COUNTY. 

(Society organized August 14, 1846. Meets second Tuesday in May and November). 

Camden 



Dowling Benjamin, Pres., Camden John F. Walsh, 

E. B. Woolston, V. Pres., Marlton S. B. Irwin, 

H. Genet Taylor, Sec'y, Camden C. M. Schellenger, 

Alex. M. Mecray, Treas., ** Wm. A. Hamilton, 

John W. Snowden, Rep., Ancora Wm. H. Ireland, 



Alexander Marcy, 
James M. Ridge, 
J. Orlando White, 

D. Parrish Pancoast, 

E. L. B. Godfrey, 
James A. Armstrong, 
E. J. Snitcher, 



Camden Wm. H. Iszard, 
Conrad G. Hoell, 
E. P. Townsend, 
Onan B. Gross, 
John W. Douges, 
H. H. Davis, 
Randall W. Morgan, 



«< 



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it 



<< 



<i 



(( 



ti 



<< 



«< 



it 



n 



<« 



MEDICAL SOCIETY OF NEW JERSEY. 



II 



Wm. A. Davis, 
N. B. Jennings, 
C. H. Shivers, 
John R. Stevenson, 
H. E. Branin, 

Joseph F. Garrison, 
Charles G. Garrison, 
J. Gilbert Young, 

No. Members, 34. 



<< 



tt 



tt 



Berlin 



Camden G.W. Bough man; Gloucester City 
Haddonfield H. A. M. Smith, 
" Edwin Tomlinson, 

D. W. Blake, 
Blackwood Daniel M. Stout, 

HONORARY MEMBERS. 

Camden Richard C. Dean, U. S. Al. 

" P. V. Schenck, St. Louis, Mo. 

Phila. J. B. Hewlings, Moorestown 

H. Genet Taylor, Secretarv. 



CUMBERLAND COUNTY. 

(Society organized Dec. 8, 1818 ) 

George Tomlinson, Pres., Shiloh Ed. H. Bidwell, 

W. L. Newell, V. Pres., Millville J. S. Whitaker, 

H. W. Elmer, Sec'y, Bridgeton W. H. C. Smith, 

Jos. Sheppard, Treas., *• Maximillian West, 

John Ingram, Reporter^ Vineland Henry C. Fithian, 



William Elmer, 
J. Barrow Potter, 
Robert W. Elmer, 
T. J. Smith, 
Charles R. Wiley, 



Bridgeton 



<< 



<( 



Ephraim Bateman, 
E. R. Bateman, 
George M. Paullen, 
Thos. E. Stathem, 



Vineland 



HONORARY MEMBER. 

Enoch Fithian, Greenwich. 



Vineland 
Millville 



n 



Port Norris 
Cedarsville 

Shiloh 
Greenwich 



No. Members, 19. 



H. W. Elmer, Secretary. 



ESSEX COUNTY. 

(Society organized June 8, 1816.) 

Wm. J. Chandler, Pres., S. Orange Charles D. Bennett, 

Wm. S. Ward, V. Pres., Newark William B. Berry, 

Archibald Mercer, Secy, " Herman C. Bleyle, 

William Rankin, Jr., Treas., " Edward DeL. Bradin, 

L. Eugene Hollister, Pep., " John H. Bradshaw, 

Charles H Bailey, Bloomfield John D. Brumley, 

Milton Baldwin, Newark Carl Btlttner, 

Aaron K. Baldwin, " James B. Burnet, 

George Bayles, Orange Robert L, Burrage, 



Newark 

Montclair 

Newark 



tt 



Orange 
Newark 

Orange 
Newark 



(( 



12 



MEDICAL SOCIETY OF NEW JERSEY. 



tt 



tt 



ti 



<< 



n 



tt 



tt 



tt 



tt 



It 



tt 



Talbot R. Chambers, Easi Orange 

J. Henry Clark, Newark 

Abram Coles, 

Joseph A. Corwin, 

Theodore W. Corwin, 

Richard G. P. Dieffenbach, 

Daniel M. Dill, 

Arthur C. Dougherty, 

Charles J. Duffy, 

John L. Duryee, 

Emma W. Edwards, 

James Elliott, 

Daniel Elliott, 

Thomas D. English, 

Joseph Fewsmith, Jr., 

Herman P. Gerbert, Orange 

Robert F. Gillin, Newark 

Thomas N. Gray, Orange Valley 

Wm. B. Grover, East Orange 

Hermann C. H. Herold, Newark 

Charles W. Hagen, 

Joseph F. Hager, 

Ella Haines, 

Thomas W. Harvey, Orange 

Joseph H. Haydon, Newark 

Hugh C. Hendry, 

Jacob Hester, " 

Peter V. P. Hewlett, 

Edgar Holden, 

William H. Holmes, Orange 

Mary D. Hussey, East Orange 

Edward J. Ill, Newark 

John E. Janes, " 

Anna H. Johnson, Orange 

George R. Kent, Newark 

Charles J. Kipp, 

Henry A. Kornemann, 

Charles F. J. Lehlbach, 

John J. H. Love, Montclair 



Thos. W. Loweree, Jr., Newark 

Ernest M. Lyon, 

William H. Mart land, 

John R. McDermott, 

Andrew M. Mills, 

Sarah R. Mead, 

William O'Gorman, 

Edward A. Osborne, 

Joseph D. Osborne, 

Samuel H. Pennington, 

William Pierson, 

W. Nick Pindell, 

J. W. Pinkham, 

A. A. Ransom, 

Joshua W. Read, 

Philip Ricord, 

Manning N. Robinson, '* 

Wm. D. Robinson, East Orange 

Hugh P. Roden, Newark 

Charles A. Schureman, " 



Orange 

Newark 

Montclair 

South Orange 

Newark 



tt 



tt 



tt 



tt 



tt 



tt 



It 



tt 



James Y. Simpson, 
Daniel M. Skinner, 
David S. Smith, 

D. Winans Smith, 

E. Fayette Smith, 
William A. Smith, 
Lott Southard, 
Robert Staehlin, 
Joseph W. Stickler, 
Charles W. Stickney, 
Robert M. Sutphen, 
Theron Y. Sutphen, 
Edwin B. Thompson, 
Francis J. E. Tetreault, 
Hiram H. Tichenor, 
Charles F. Underwood, 
M. H. Cash Vail, 
Stephen W. Van Duyn, 
George A. Van Wagenen, 



Orange 

Belleville 

Irvington 

Newark 



tt 



tt 



tt 



Orange 
Neivark 



tt 



tt 



Orange 



tt 



Newark 



tt 



It 



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<# 



MEDICAL SOCIETY OF NEW JERSEY. 



13 



David L. Wallace, 
Arthur Ward, 
Edward M. Ward, 
James H. Ward, 
Leslie D. Ward, 
Henry B. Whitehorne, 

No. Members, 108. 



Newark Ed. T. Whittingham, Mtllburn 

" Stephen Wickes, Orange 

Bloomfield James T. Wrightson, Newark 

Newark Charles Young, 

" Joseph C. Young, Jr., 

Verona Charles M. Zeh, 

Archibald Mercer, Secretary. 



«< 



« 



«< 



GLOUCESTER COUNTY. 

(Society organized December, z8i8.) 



L. M. Halsey, Pres,, Williamstown 
George C. Laws, Sec'y and 

Treas., Paulsboro 
B. F. Buzby, Rep,, Swedesboro 
Albert Trenchard, Mantua 

S. D. Fisler, Clayton 

No. Members, 10. 



H. C. Clark, 
L. A. D. Allen, 
Eugene Oliphant, 
John Ashcraft, 
L. F. Halsey, 



Woodbury 

Woodstown 

Buckingham 

Mullica Hill 

Swedesboro 



George C. Laws, Secretary. 



HUDSON COUNTY. 

(Society organized October i, 1851.) 



G. K. Dickinson, Pres, 


, Jersey City 


John Keating, 


Jersey City 


W. P. Watson, V, Pres,, 


George W. King, 


Snake Hill 


J. A. Exton, Secy, 


Arlington 


John Lochner, 


Jersey City 


C. F. Kyte, Treas., 


Jersey City 


J. T. Luck, 


tt 


George F. Pitts, Rep., 


Hoboken 


T. Lynch, 


Hoboken 


E. P. Buffett, 


Jersey City 


Wm. J. Mackey, 


tt 


C. W. Cropper, 


<< 


W. J. McDowell, 


Jersey City 


Benj. Edge, 


<( 


T. F. Morris, 


tt 


L. W. Elder. 


Hoboken 


F. E. Noble, 


t% 


S. R. Forman, 


Jersey City 


Thos. C. O'Callahan, 


tt 


John Faber, 


(. 


W. J. Parker, 


tt 


L. J. Gordon, 


<< 


James Paul, 


tt 


D. S. Hardenburg, 


K 


L N. Quimby, 


<• 


S. A. Heifer, 


Hoboken 


D. L. Reeve, 


(< 


Peter Hoffman, 


Jersey City 


H. E. Rothe, 


Harrison 


John P. Henry, 


(< 


M, F. Squires, 


tt 



14 

"■«*,■„■ *,«,,;"** »-«s>". """-*"% 

'^'""'Sar!' '"'-', •"■'■•'J.;,, 



MEDICAL SOCIETY OF NEW JERSEY. 



15 



J. I. B. Ribble, 


Trenton 


Edgar Hart, 


Pennington 


Wm. Elmer, Jr., 


tt 


Alex. M. Stein, 


Trenton 


Lyman Leavitt, 


it 


Joseph S. Laning, 


Woodsville 


Thomas H. Mackenzie, 


ti 


Charles Leavitt, 


Trenton 


John W. Ward, 


Asylum 


Charles H. Mcllwaine, , " 


Wm. S. Lalor, 


Trenton 


R. R. Rogers, Jr., 


it 


Charles H. Dunham, 


<< 


0. G. Sands, 


Titusville 


Charles P. Britton, 


(< 


H. G. Wetherill, 


Asylum 


H. Schafer, 


<< 






No. Members, 45. 




Wm. a. Clark, 


Secretary. 



MIDDLESEX COUNTY. 

(Society organized June 16, 1816. Meets third Wednesday, Jan., Apr., July and Oct.) 

T. L. Janeway,/*., New Brunswick N. Williamson, New Brunswick 



F.M.Donohue, V.P.&^Rep.r 

Wm. Mabon, Secy, 

D. C. English, Treas., 

H. R. Baldwin, 

A. V. N. Baldwm, 

George G. Clark, 

John Helm, 

J. L. Van Deventer, 

C. H. Voorhees, 

No. Members, 20. 



<( 



<< 



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n 



tt 



A. Treganowan, 
John H. Carman, 
C. H. Andrus, 
A. C. Hunt, 
E. M. Hunt, 
S. M. Disbrow, 
H. D. Zandt, 
J. C. Holmes, 
W. V. Wilson, 



South Amboy 
Metuchen 



tt 



Trenton 

Old Bridge 

Jamesburg 

Cranbury 

Dayton 



Wm. Mabon, Secretary. 



MONMOUTH 

(Society organized 

Asher F. Applegate, Englishtown 
J. E. Arrowsmith, Keyport 

L N. Beegle, Ocean Grove 

Robert R. Conover, Red Bank 
Henry G. Cook, Holmdel 

J. E. Cooper, Colt's Neck 

Stephen A. D\shroyN,Farmingdale 
V. M. Disbrow, 

Edward Field, Red Bank 

D. M. Forman, Freehold 



COUNTY. 

July 16, 1816.) 

J. B. Goodenough, Long Branch 
Dan. D. Hendrickson,il//V/<://^/^?w« 
S. H. Hunt, Long Branch 

George Hutchinson, Englishtown 
A. J. Jackson, Matawan 

Samuel Johnson, Ocean Grove 
Wm. R. Kinmouth, Farmingdale 
L S. Long, Freehold 

Henry Mitchell, Asbury Park 
Harry Nafie, Blue Ball 



i6 



MEDICAL SOCIETY OF NEW JERSEY, 



H. G. Norton, Imiaystown C. D. W. Van Dyck, PerrinevilU 

James H. Patterson, Shrewsbury George T. Welch, Keyport 

Edgar Roberts, Keyport George F. Wilbur, Asbury Park 

Chas. H. Thompson, Ocean Beach 

HONORARY MEMBERS, 

Edward Taylor, Middletown S. M. Disbrow, 

A. A. Howell, Allentown Robert Laird, 

A. V. Conover, Freehold. 

No. Members, 27. 



Farmtngdale 
Manasquan 



MORRIS COUNTY. 

(Society organized June x, x8z6.) 

W. Pennington, P., Baskingridge T. B. Flagler, 
A. A. Lewis, V, Pres., Morristown H. Hulshizer, 
Fred. W. Owen, Sec^y^ '* Smith Hedges, 



C. Anderson, 
H. B. Andrew, 

D. S. Ayres, 
P. C. Barker, 

A. E. Carpenter, 
I. W. Condict, 

E. P. Cooper, 

T. R. Crittenden, 
G. O. Cummings, 
H. V. Day, 
J. S. Farrow, 
Levi Farrow, 

C. Y. Swan, 



Madison J. C. Lindsley, 

Morristown L. W. Case, 

Rockaway A. A. Mac withy, 

Morristown Stephen Pierson, 

Boonton J. Riches, 

Dover Wm. H. Risk, 

Parsippany Ed. G. M. Ross, 

Dover J. G. Ryerson, 
I. H. Stiger, 

BloomingdaU J. S. Stiger, 

Flanders H. C. Wiggins, 

Middle Valley E. E. Smith, 

HONORARY MEMBERS. 

Morristown N. Condict, 



Morristown 

Port Oram 

Chester 

Morristown 

Chester 

Pompton 

Morristown 

Succasunna 

Summit 

Dover 

Boonton 

Mendham, 



«( 



Succasunna 
Hanover 



No. Members, 30. 



Morristown 
Fred. Wooster Owen, Secretary. 



OCEAN COUNTY. 

J. M. Bean, Pres,, New Egypt E. C. Disbrow, Rep,, Toms River 

P. K. Hilliard, V.P.,Mannahawkin I. C. Schureman, Secy, 

R. L. Disbrow, Tr^a J., Toms River G. S. Tunis, Burrsville 

No. Members, 6. I. C. Schureman, Secretary. 



MEDICAL SOCIETY OF NEW JERSEY. 



17 



PASSAIC COUNTY. 

(Society organized July 14, 1844.) 

J. C. Herrick, Pres.y Passaic C. F. W. Meyers, 

G. H. Balleray, V, Pres.^ Paterson . E. J. Marsh, 
Philander A. Harris, S^cy and R. Neer, 

Rep., Paterson Wm. K. Newton, 



Paterson 



it 



<( 



G. W. Terriberry, Treas,, 


T. F. O'Grady, 


<< 


James C. Amireaux, 


'* Henry Parke, 


(< 


J. H*. Banta, 


J. P. Paxton, 


4( 


J. S. Bibby, 


John Quin, 


<( 


Wm. Blundell, 


" F. H. Rice, 


Passaic 


6. V. Gamett, 


A. W. Rogers, 


Paterson 


J. Henggler, 


James W. Smith, 


n 


W. B. Johnson, 


Calvin Terriberry, 




T. J. Kane, • 


Garrett Terhune, 


Passaic 


Henry- Kip, 


" Richard A. Terhune. 


tt 


John L. Leal, 


Spencer Van Dalsen, 


Paterson 


J. H. Mackintosh, * 


H. C. Van Gieson, 


it 


S. F. Mackintosh, 


' C. Van Riper, 


n 


E. S. McClellan, • ' 


' C. S. Van Riper, 


Passaic 


S. R. Merrill, 


Henry Davis Withers, 


Paterson 


M. Moss, 


A. R. Wolfe, 


n 


No. Members, 39. 


Philander A. Harris, Seci'etary. 



SALEM COUNTY. 

(Society organized November 30, 1818.) 

B. A. Waddington, Pres., Salem — Garrison, 



F. Bilderback, Vice Pres., 
L. W. Reed, Secy and Treas., 

Woodstown 
C. M. Sherron, Rep., 
J. H. Thompson, 
Q. Gibbon, 
James Patterson, 
A. G. McPherson, 

No. Members, 17. 



M. J. Paulding, 
U. Gillman, 
L. L. Glover, 
Salem W. L. Ewen, 
L. A. D. Allen, 
B. F. Buzby, 
S. F. Stanger, 



(< 



<< 



« 



Penttsville 

Daretown 

Woodstown 

Hancock Bridge 

Alloway 

Woodstown 

Surdesboro 

Harrisonville 

Glassboro 



Quinton J. D. Heritage, 

L. W. Reed, Secretary. 



i8 



MEDICAL SOCIETY OF NEW JERSEY. 



SOMERSET COUNTY. 

(Society organized May, x8x6.) 



Somerville 

North Branch 

Bound Brook 



W. J. Swinton, Pres.^ Somerville A. P. Hunt, 

S. O. p. Taylor, V.Pres., Millstone J. F. Berg, 

H. F. Van Der Veer, R, Sec'y, B. B. Matthews, 

Somerville I. L. Compton, " 

J. P. Hecht, Cor. Sec'y, Raritan C. R. P. Fisher, 

W. H. Merrill, Treas., S. Branch Geo. V. Van Nest, East Millstone 

W. B. Ribble, Rep,, East Millstone Abram Mosher, Griggstown 



No. Members, 13. 



J. P. Hecht, Cor. Secretary. 



SUSSEX COUNTY. 

(Society organized August as, 1899.) 



J. B, Pellet, Pres,, 
C. Davison, V, Pres., 
L. D. Miller, Sec'y, 
E. Morrison, Treas,, 
Thomas Ryerson, 
J. Linn Allen, 
Joseph Hedges. 
P. N. Jacobus. 
E. Schumo. 
John Moore. 
Edgar Potts, 
Carlos Allen. 
T. Andress, 



Newton 



44 



44 



Hamburg 

Beemerville 

Branchville 

Andauer 

Stillwater 



Hamburg J. P. Couse, 

Stanhope B. F. Ferg^sson, 

J. C. Price, 

J. Miller, 

C. V. Moore, 

Lafayette H. C. Van Gaesbeck, Deckertown 

Branchville J. F. McCloughan, Swartswood 

Newton Wm. H. Douglass, 
Branchville J. C. Strader, 
Deckertown J. N. Miller, 
Coleville Martin Cole, 
Vernon Austin W. Condit, 
Sparta 

HONORARY MEMBER. 

Franklin Smith, Xe^fton. 



Ogdensburg 

Lafayette 

Laytons 

Montague 

Andover 



No. Members. 25. 



L. D. Miller. Secretary. 



UNION COUNTY. 

V Society ors^-ini/ed June 7, X8C9.) 

T. N. McLean. Prcs., Eli::abeth J. K. McConnell. 

T . H . Tom 1 i nso n , r. /*. . Pla injield J . B. Probasco. 

\V. A. M. Mack. Secy. Elisabeth Wm. K. Gray, 

J. A. Coles, Treas.. Stotch P Jains H. D. Burlingham. 



CraiL.ford 

Plainjidd 

East Orange 

Plainfield 



MEDICAL SOCIETY OF NEW JERSEY. 



19 



M. B. Long, Rep., 
L. W. Oakley, 
H. H. James, 
James S. Green, 
Alonzo Pettit, 
J. Otis Pinneo, 

D. W. C. Hough, 
F. A. Kinch, 
Thomas Terrill, Jr., 
William Gale, 
Joseph H. Grier, 
W. U. Selover, 

E. B. Silvers, 
Thomas L. Hough, 
Robert Westcott, 
J. S. Crane, 

No. Members, 39. 



Plainfield 
Elizabeth 
Rahway 
Elizabeth 



<< 



<< 



Rahway 
Westfield 
Elizabeth 

Westfield 
Elizabeth 

Rahway 



it 



Elizabeth 



n 



n 



Walter E. Cladek, 
Victor Mravlag, 
David Schleimer, 
Lewis Drake, 
Charles A. Hart, 

F. W. Westcott, 
J. B. Harrison, 
J. J. Daly, • 

H. Page Hough, 

G. W. Endicott, 
J. H. Pickett, 

C. M. Field, 
C. S. McKnight, 
A. Q. Donovan, 
R. Braun, 



Rahway 
Elizabeth 



it 



Rahway 

Plainfield 

Scotch Plains 

Westfield 

Rahway 

Plainfield 

Elizabeth 

Plainfield 
(< 

Elizabeth 
tt 



Wm. a. M. Mack, Secretary. 



P. F. Brakeley, 
S. S. Clark, 
J. M. Paul, 
W. H. McGee, 
John C. Johnson, 
M. N. Armstrong, 
John S. Cook, 
Theodore Crane, 

No. Members, 16. 



WARREN COUNTY. 

(Society organized February 15. 1826.) 

Belvidere Alva C.Van Syckle, Hackettstown 

" P. F. Hulshizer, Stewartsville 

L. C. Osmun, Delaware 

Wm. M. Hartpence, Washington 

Blair stown John H. Griffith, Phillipsburg 

" Isaac Barber, 

Hackettstown Robert A. Stewart, 

■ " J. J. Roe, Vienna 

P. F. Brakeley, Secretary. 



(< 



<< 



<( 



<< 



SUMMARY. 



Atlantic, 


- 17 


Monmouth, 


- 27 


Bergen, 


23 


Morris, 


30 


Burlington, - 


- 32 


Ocean, - 


- 5 


Camden, - 


34 


Passaic, 


39 


Cumberland, - 


- 19 


Salem, 


- 17 


Essex, 


- 108 


Somerset, - 


13 


Gloucester, - 


- 10 


Sussex, - 


- 25 


Hudson, - 


37 


Union, 


39 


Hunterdon, - 


- 18 


Warren, - 


- 16 


Mercer, 


45 






Middlesex, 


- 20 




574 



TRANSACTIONS 



OF THE 



Medical Society of New Jersey 



The One Hundred and Eighteenth Annual Meeting. 



Stockton Hotel. Cape May. 



TUESDAY. JUNE lo, 1884. 

The meeting was called to order in the dining room of 
the Stockton Hotel at four o'clock by the President, Dr. 
Wickes. 

After prayer by the Rev. G. F. Bishop, of Cape May, 
the Committee on Organization reported as follows : 

The Committee on Organization would respectfully 
report : 

DELEGATES. 

Atlantic — T. K. Reed*, J. B. Somers*, D. B. Ingersoll. Members, 

17. 
Bergen— Ti, A. Currie*, J. W. Terry* John W. Hopper*, A. S. 

Burdett, D. St. John*. Members, 23. 

Burlington— L. L. Sharp, W. E. Hall, W. H. Shipps, Wm. P. 
Melcher, J. Reeve, George Goodell. Members, 32. 

Camden — A. M. Mecray, H. G. Taylor, W. H. Iszard, E. Tomlin- 
son, H. E. Brannin, E. L. B. Godfrey. Members, 34. 

Cumberland— Q, R. Wiley, E. Bateman*, J. S. Whitaker, R. W. 
Elmer. Members, 19. 



22 MEDICAL SOCIETY OF NEW JERSEY. 

Essex— H. E. Hollister, W. H. Holmes, J. C. Young, Joseph Few- 
smith, R. F. Gillen, T. N. Gray, W. B. Grover, J. F. Hager, H. C. H. 
Herold, J. W. Stickler, David Smith, George A. Van Wagenen, C. 
Bailey. Members, io8. 

Gloucester —George C. Laws, H. C. Clark, L. A. D. Allen, Eugene 
Oliphant. Members, ii. 

Hudson—S. A. Heifer, Peter Hoffman, C. A. G. Schuhl, W. P. Wat- 
son, I. N. Quimby, H. B. Rue. Members, 37. 

Hunterdon — N. B. Oliphant, George L. Romaine*, Isaac S. Cramer, 
O. H. Sproul, J. F. Leaviit. Members, 18. 

Mercer — ^John W. Ward, R. R. Rogers, Jr., Charles H. Mcllvaine, 
Lyman Leavitt, O. G. Sands, W. A. Clark, D. Warman. Members, 45. 

Middlesex — D. C. English, A. V. N. Baldwin, Wm. Mabon, A. C. 
Hunt. Members, 20. 

Monmouth — ^J. E. Arrowsmith*, S. H. Hunt*, Charles H. Thomp- 
son*, N. G. Norton*, George T. Welch. Members. 27. 

Morris—]. G. Ryerson, T. B. Flagler, Wm. Pennington*, E. P. 
Cooper, L. Farrow, A. A. Lewis, T. R. Crittenden. Members, 30. 

Ocean — P. R. Hillard*, J. C. Schureman, R. L. Disbrow*. Mem- 
bers, 6. 

Passaic — J. C. Herrick, C. Van Riper*, W. K. Newton* George 
Terriberry*, S. R. Merrill. Members, 39. 

5«/<?w—M. J. Paulding, L. W. Reed, L. L. Glover, U. Gilman. 
Members, 17. 

Somerset—]. L. Compton* H. F. Van Der Veer* C. R. P. Fisher, 
W. B. Ribble. Members, 13. 

Sussex - E. Schumo*, A. H. Douglas* F. Andruss*, J. P. Couse*, 
B. F. Ferguson*. Members, 25. 

Union — H. H. James, T. H. Tomlinson, J. O. Pinneo*, W. W. Sel- 
over, T. N. McLane, J. A. Coles. Members, 35. 

Warren — John S. Cook*, S. S. Clark, P. F. Hulshizer, P. F. Brake- 
ley*. Members, 16. 

Reporters — Atlantic, John E. Sheppard* ; Bergen, J. M. Simpson* ; 
Burlington, S. C. Thornton* ; Camden, J. W. Snowden ; Essex, W. J. 
Chandler ; Gloucester, B. F. Buzby ; Hudson, G. F. Pitts* ; Hunter- 
don, C. W. Larison*; Mercer, H. M. Weeks; Middlesex, F. M. Dono- 
hue*; Monmouth, D. E. Roberts* ; Morris, S. Pierson* ; Somerset, 
W. B. Ribble ; Sussex, L. D. Miller* ; Union, M. B. Long ; Warren, 
J. Griffith*. 



MINUTES. 23 

OFFICERS : 

President — Stephen Wickes. 

First Vice President — P. C. Barker. 

Second Vice President — Joseph Parrish, 

Third Vice President— Q. J. Kipp, 

Corresponding Secretary — William Elmer, Jr. 

Recording Secretary — William Pierson. 

Treasurer—^. W. L. Phillips. 

Standing Committee — T. J. Smith. S. S. Clark, E. J. Marsh*. 

William Pierson, 
W. W. L. Phillips, 
W. P. Watson, 

Committee. 
On motion, the report was adopted. 

Fellows — The following Fellows were present : S. H. Pennington, 
Wm. Elmer, John Woolverton, E. M. Hunt, F. Gauntt, G. H. Larison, 
H. R. Baldwin, A. W. Rogers, L. W. Oakley, J. W. Snowden. 

Dr. H. G. Taylor, on behalf of the Committee of 
Arrangements, reported as follows : 

Mr. President and Members of the New Jersey Medical Society : 

As Chairman of the Committee of Arrangements for our one hun- 
dred and eighteenth annual meeting, I am called upon to perform an 
agreeable duty in reporting to you that the committee, both collect- 
ively and individually, have endeavored to make the second session at 
this great seaside resort of benefit to all attending. 

Through the influence and exertions of Drs. Mecray and Carll, of 
Cape May County, we are largely indebted for the local arrangements 
here to-day. The Stockton Hotel, one of the largest seaside hotels 
on the coast, has been secured for our meeting, and with its ample 
accommodations for an unlimited number of guests, was expected to 
be opened at this date, but as arrangements could not be perfected in 
time, it was obtained for the holding of the session. 

The local committee, composed of the prominent citizens and cot- 
tagers, have generously responded, and offer as a slight testimonial 
of their appreciation of your visit a banquet at the Hotel Lafayette 

♦Absent. 



24 MEDICAL SOCIETY OF NEW JERSEY. 

this evening, followed by a " hop " at the New Columbia — ^the latter, 
I presume, is intended as a token of regard for the fair sex you bring 
with you — and we trust the enjoyment of both banquet and hop will 
be a further incentive for the ladies to honor us at all times by their 
presence at our annual meetings. 

To-morrow there will be an excursion to Sewell's Point, a place 
noted for its fishing grounds. I believe the hour will be one o'clock. 
The Government Life Saving Service will also give you an exhibition 
drill about six o'clock this evening, and as many of you were not able 
to witness it at Atlantic City last year, we have arranged it to take 
place after the first session to-day, and hope all who are interested in 
this noble and arduous undertaking will avail themselves of the com- 
plimentary exhibit. • 

The officers of the West Jersey Railroad Company, with their usual 
liberality, have placed at your disposal a complimentary train, which 
will return to Camden at five o'clock to-morrow afternoon, and for 
those wishing to leave earlier, or who may be disposed to remain a 
day or so after the adjournment of the session, the benefit of all 
trains to Philadelphia will be at their disposal. 

in conclusion, we would add that the committee have had some 
obstacles to overcome in making this the fourth visit of our Society 
to the two well-known South Jersey seaside resorts an agreeable and 
pleasant session, and also in overcoming a too generous reception by 
the residents and cottagers here. 

We have at this meeting endeavored not to infringe upon the busi- 
ness hours of the Society, nor to give to you an excess of hospitality. 
We regret that the Advisory or Regulating Committee, appointed 
at the last meeting at Atlantic City, were not able to attend the 
preliminary meetings of the committee, but we believe they are 
fully in accord with the arrangements that have been made. 

Your committee earnestly trust that the one hundred and eigh- 
teenth session of our Society will be remembered as one of the most 
profitable and pleasant meetings, and that the distinguished guests 
from our own and sister States, here present, will carry to their homes 
pleasant recollections of the day spent with the Medical Society of 

New Jersey. 

Respectfully submitted, 

H. Genet Taylor, 

Chairman Committee of Arrangements, 
June lo, 1884. 



MINUTES. 25 

The report was adopted. 
Then followed the address of welcome. 

Mr. President and Gentlemen of the Medical Society of New Jersey : 
It has fallen to my lot to extend to you a welcome, which I most 
heartily do, on this your second visit to our city. Since your last 
visit, in 1876, we have been visited by a destructive conflagration, 
sweeping out qi existence all of our largest hotels, except this one in 
which you are now assembled. But Cape May, like Phoenix, has 
risen from its ashes, and you now see in the place of the lost other 
structures equally imposing, two of which are brick, and all in arch- 
itectural beauty and magnificence of appointments second to none in 
any watering place in the world. We have here everything to please 
the eye, rest and refresh the body, restore health to the enfeebled, and 
give enjoyment and recreation to the seeker of pleasure. There are 
many things of which we feel justly proud, our magnificent beach, 
affording perfectly safe bathing by its very gradual descent and 
regular, hard, smooth surface, with the fast land coming down to 
the very edge of the water. Our excellent, well-planned sewer 
system, laid down in almost every one of our streets, having 
sufficient fall to quickly carry off all effete matter far away 
from the town, giving such a sanitary condition that the mortality 
of both city and county is the lowest of any in the State. This is 
not a thing in prospect, depending upon companies to complete, 
but au fait accompli, and that by our own efforts. Our State 
Board of Health, through its secretary, has expressed unqualified ap- 
proval and commendation of our system. Nor are our hotels and 
boarding houses a whit behind in their internal sanitary arrangements. 
Not less than 1 10,000 was expended in this hotel alone during last 
year in replacing and improving its drains and general sanitary ar- 
rangements. The same care has also been exercised in all our other 
hotels, both large and small. We believe we can safely assure our 
visitors against dangers from septic influences. Our water supply is 
in most excellent condition, furnishing about one million gallons daily, 
and distributed through all the most thickly settled portions of the 
town, giving an abundant supply of excellent, pure, fresh water, not 
from surface springs, but drawn from the very bowels of the earth 
and stored in three large tanks, and from them distributed through 
mains to every part of the city, furnishing a freshly drawn supply con- 



26 MEDICAL SOCIETY OF NEW JERSEY. 

stantly, and not from stagnant ponds or reservoirs. Our fire depart- 
ment is worthy of mention, consisting of two steam fire engines of 
the best construction, with hose carts, hook and ladder truck, and a 
well organized and drilled fire department. A pair of well trained, 
powerful horses are kept by the city, ready at the first tap of the bell 
to draw the engines to the place of danger. Our costly experience of 
1878 has led us to see well to it that every possible appliance is ready 
to meet such emergencies. 

Our beach drive, extending from the western limits of the city to 
Cold Spring inlet, on the very edge of the surf, a distance of four miles, 
needs no comment, as it is only to see it to admire it. Then, too, 
we can with just pride point to our noble iron pier, which you can now 
see nearing its completion, stretching out its long arm to the winged 
messengers of the deep, and inviting them to fold their wings and rest 
themselves by its strong sides. It is 1,000 feet in length and 30 in 
width. At its terminal end a depth of 20 feet of water furnishes no 
less than six landing places for vessels, at which they may rest in 
security. It is built by the Phoenix Bridge Company, of Pennsylvania, 
whose very name gives" a guarantee of its security and completeness. 
The immunity which the trend of the shore line and a natural break- 
water about two miles from the shore gives us from the destructive 
force of the waves in heavy storms, will make our pier a place of resort 
for steam and sailing vessels during all the year. Then, too, not to be 
behind other places of resort, a noble elephant rears his huge head 
and body about one mile west of the town, and will undoubtedly be 
as great a source of wonder and amusement as the celebrated Light 
of Asia of Barnum, or at least as his compeers of other places. We 
would only mention our drives about the city, along the beach front 
and throughout the county as unsurpassed by any seaside resort ; our 
two railroads, the one 2j miles to Cape May Point and steamboat 
landing on the bay shore, the other to Sewell's Point two miles to 
Cold Spring inlet, both in a short ride carrying visitors to as good 
sailing and fishing grounds as can be found in the State. We will 
not consume your time by mentioning facts relative to our humidity, 
temperature and prevailing winds, but would refer to a very able re- 
port of Prof. Smock, Assistant State Geologist, well worth perusal by 
all seeking healthful, pleasant resort, either summer or winter. Some 
remarkable facts are brought to light in this report, giving us the ad- 
vantage over all other seaside resorts in equableness of temperature, 



MINUTES. 2^ 

in this country, with the single exception of Key West. I fear, gen- 
tlemen, that I have already trespassed too long on your time and 
patience and will therefore close, by again bidding you welcome, 
hearty welcome to the hospitalities of our city, and trust you will 
frequently in the future cheer us with your presence. 

He was followed by his Honor, the Mayor of Cape 
May, who in a very happy manner expressed the satis- 
faction it gave him to welcome the Society to the city. 

The minutes of the last annual meeting were read and 
approved. 

On motion of Dr. Godfrey it was voted that the follow- 
ing named gentlemen — Drs. B. Lee, Wm. Welch, W. K. 
Baldwin, W. B. Atkinson, J. C. Hall, P. H. AlHs, J. J. 
Leavitt, R. J. Levis, H. F. Forman, Hiram Corson, W. 
B. Ulrich, E. L. Green, W. R. D. Blackwood, F. H. 
Woodbury, of Pennsylvania, and J. H. Hunt, of New 
York, and all physicians who may be present from this or 
any other State — be invited to seats as corresponding 
members. 

A telegram was received and read from the Governor 
of this State regretting his inability to be present at this 
meeting. 

The Business Committee presented their printed pro- 
gramme as its report, which was on motion accepted. 

D. B. Ingersoll, delegate to the American Medical Asso- 
ciation ; D. C. English, delegate to the Medical Society 
of Connecticut, and D. Benjamin, read their respective 
reports. All were, on motion, voted to be referred to 
Committee on Publication. 

Dr. Hunt stated that the meeting of the Medical Society 
of Massachusetts is held at the same time as ours, and 
that Dr. North, our delegate, is in attendance at this 
meeting. 



1 



28 MEDICAL SOCIETY OF NEW JERSEY. 

The Committee on Medical Ethics reported as follows : 

The Standing Committee, as a Committee on Medical Ethics, would 
report in the case of appeal of Dr. Warman from the Mercer District 
Society, that there is no ground for appeal. 

T. J. Smith, 
E. J. Marsh, 
S. S. Clark, 

Committee, 

On motion the report was adopted. 

On motion, the order of business was suspended, in 
order to allow the Committee on Treasurer's Accounts to 
report. 

The following is the report : 

The Committee whom you, at the last annual meeting of the 
Society, directed to examine the accounts of the Treasurer, would 
respectfully report : 

Amount received from late Treasurer, on de- 
posit in Newark Savings Institution, 1874 $2,169 75 

Cash 30 00 

Total $2,19975 

Receipts from all sources, 1875 990 00 

1876 874 GO 

1877 942 00 

1878 1,027 25 

1879 943 00 

1880 503 00 

1881 1,041 00 

1882 1,068 00 

Receipts from interest on U. S. Bonds 166 50 

Savings Fund 257 74 

Newark Savings Institution 2,259 H 



4( <( i< 

4< 4< <( 

<< i( << 

<t <( <( 

l< 4( i< 

<( <( << 

i( << «< 

ceipts from interest c 

<< << <t 

<< << 



Total receipts from 1874 to 1883 $12,271 38 



« 



it 



<( 



(( 



(( 



tt 



it 



ti 



MINUTES. 29 

DISBURSEMENTS. 

As per Vouchers, 1 874 $587 22 

1875 901 18 

1876 81602 

1877 803 14 

1878 722 75 

1879 1,472 96 

1880 541 18 

1881 . 1,90618 

1882 1,159 83 

Purchase of U. S. 4 per cent. Bonds 1,716 70 

Total disbursements from 1874 to 1883 $10,627 16 

Deduct $10,627.16 (total disbursements) from $12,271.38 (total 
receipts), leaving a balance of $1,644.22 assets, $1,550 of which are 
U. S. 4 per cent. Bonds, and a balance of $182.81 remaining in the 
Newark Savings Institution and $88.99 ^^ the hands of the Treasurer. 

As directed by the Society, Dr. Phillips has furnished a bond to the 
amount of $5,000, which is now in the possession of the Secretary. 

The Committee does not hold itself responsible for the validity of 

the bond, but believes it to be good. 

L. W. Oakley, 

H. Genet Taylor, 

H. M. Weeks, 

Committee. 
On motion, the report was adopted. 

On motion of Dr. Oakley, it was ordered that the 
Treasurer be instructed to exchange the U. S. 4 per cent. 
Bonds for U.S. Registered Bonds, at his very earliest 
convenience. 

Order of business resumed. 

The Secretary announced the following as the Nomi- 
nating Committee. The names were reported to him by 
the several delegations. The President appointed Dr. S. 
S. Clark as the chairman : 

NOMINATING COMMITTEE. 

Atlantic, D. B. Ingersoll ; Burlington, W. H. Shipps ; Camden, C. 
M. Mecray ; Cumberland, C. R. Wiley ; Essex, D. Smith ; Gloucester, 



30 MEDICAL SOCIETY OF NEW JERSEY. 

G. C. Laws ; Hudson, W. P. Watson : Hunterdon, J. S. Cramer ; 
Mercer, L. Leavitt ; Middlesex, Wm. Mabon; Monmouth, George T. 
Welch ; Morris, J. G. Ryerson ; Ocean, J. C. Schureman ; Passaic, J. 
C. Herrick ; Salem, L. W. Reed ; Somerset, W. B. Ribble ; Union, H. 
H. James ; Warren, S. S. Clark. 

The President appointed the following committees : 

Committee on Treasurer s Accounts — L. W. Oakley, H. G. Taylor, 
H. M. Weeks. 

Committee on Unfinished Business — Wm. Elmer, W. J. Chandler, 
Joseph C. Young. 

On motion the Society adjourned till 7.30 P. M. 

SEVEN THIRTY O'CLOCK. 

The Society reassembled, the President in the chair. 

On m6tion the order of business was suspended to allow 
the Treasurer, Corresponding Secretary and Committee 
on Unfinished Business to report. 

The report of the Treasurer was received and referred 
to Committee on Treasurer's Accounts. (See Appendix.) 

The Corresponding Secretary read his report, which 
was on motion adopted. (See Appendix.) 

The Committee on Unfinished Business reported that 
there is no unfinished business excepting what appears on 
the printed programme. 

Order of business resumed. 

The President then delivered the annual address, the 
subject of which was *' Living and Dying ; their Physics 
and Psychics.*' 

The subject was ably handled, and was received with 
manifest interest by the Society. 

On motion of Dr. Gauntt the thanks of the Society 
were voted to the President for his address, and a copy 
requested for publication in the Transactions. 

Dr. Pennington, in behalf of the Committee on Educa- 



MINUTES. 3 1 

tion, made a verbal report, and offered the following 
resolutions : 

Resolved, That this Society approve and adopt the recommenda- 
tions of the Special Committee on the Curriculum of preparation to 
be required of persons contemplating the study of medicine in this 
State, as contained in the report presented at the last annual meeting 
of this Society. 

Resolved, That to carry out the recommendations of said report in 
regard to censorship, as therein contemplated, the Society is of opinion 
that two Boards of Censors be appointed, consisting each of five 
members of this Society, one for the northern and one for the south- 
ern part of the State, to whom should be presented for approval the 
credentials of all persons proposing the study of medicine, and, in 
case of the insufficiency of such credentials, to examine the applicant 
in the branches of science and learning indicated in the report of the 
committee. 

Resolved, That the Standing Committee prepare and report to the 
Society for its adoption, such amendments of its By-Laws as are nec- 
essary to carry out the plan and recommendations of the committee. 

Resolved, That the Corresponding Secretary communicate the ac- 
tion of this Society on this subject to the District Medical Societies 
of this State, with instructions to adopt such regulations as shall 
effectually secure the observance of the measures adopted by this 
Society in their several localities. 

Resolved, That the Corresponding Secretary communicate the ac- 
tion of this Society on this subject to the State Medical Societies of 
the several Commonwealths of the Union, and respectfully request 
their co-operation with us in this effort to elevate the standard of 
medical education throughout the country. 

On motion, it was ordered that the consideration of the 
resolution be made the first order of business at the 
morning session. 

Report of Standing Committee. 

A motion to postpone the reading of the report until 
the morning session was offered by Dr. Elmer, but was 
not carried. 



32 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Smith, the Chairman of the Committee, then pro- 
ceeded to read its report. When about half through, he 
was interrupted by a motion offered by Dr. E. M. Hunt, 
that the further reading of the report be postponed until 
the morning session, the time to be arranged by the 
Committee of Arrangements. Carried. 

On motion, the Society adjourned until to-morrow, at 
9 A. M. 

WEDNESDAY, TEN O'CLOCK A. M. 

President in the chair. 

The resolutions presented by the Committee on Educa- 
tion were taken up seriatim for consideration. Drs. E. 
M. Hunt, B. A. Watson, Ridge, Godfrey and English 
urged their adoption. Drs. Kipp and Welch opposed 
their adoption. The second resolution was amended so 
that the Board of Censors shall be ** appointed by the 
Standing Committee each year. The word " States ** was 
substituted for " CommpnwealtKs.** 

On motion of Dr. Parrish, the resolutions as a whole 
were then adopted. 

Dr. E. M. Hunt offered the following, which was 
adopted : 

Resolved, That the Committee on Education be continued, and be 
asked to report next year to the Society what is feasible to be done to 
test the competency of graduates of various medical colleges who 
hereafter seek to settle in this State. 

Dr. E. M. Hunt also presented the following, which 
was adopted : 

Resolved, That a committee of three be appointed by the chair, to 
report this afternoon, what in its judgment can or ought to be done 
by County Medical Societies, or by local oflficot *^. t > pn**'ent unlicensed 
persons who record imperfect licenses fron: this State. 



MINUTES. 33 

The President appointed Drs. Parrish, Pennington and 
Welch as the committee. 

Dr. Smith completed the reading of the report of the 
Standing Committee. Drs. Gauntt, Ridge, Quimby, E. 
M. Hunt, D. C. English, Hulshizer and Rogers availed 
themselves of the privilege of the five minutes rule to re- 
mark upon the same. 

On motion of Dr. Benjamin it was voted that the report 
be adopted and published in the Transactions. 

The report on Medical Jurisprudence was by request of 
the committee and consent of the Society made by Dr. 
Garrison. 

Dr. Benjamin moved that the report be referred to a 
committee of five, and that it may report any modifica- 
tion at the next annual meeting. Not carried. 

Dr. Hunt moved that it be referred back to the original 
committee for amendments. Carried. 

Dr. Hunt offered the following, which was adopted ; 

Resolved, That this Socie^' recognizes the importance of some 
legislation as to the modes of securing expert testimony. 

The report of the Committee on Army Medical Museum 
and Library of Surgeon-General's Office was presented 
by Dr. A. B. Watson, its chairman. (See Appendix.) 

The following resolutions, which were appended to the 
report, were adopted : 

Whereas, It is learned witii regret that both these collections are 
in great jeopardy from tire or accident through the insecurity and 
unsuitableness of the building in which they are stored ; it is 

Resolved, That Congress be respectfully urged to provide suitable 
indestructible quarters for these invaluable treasures, to secure them 
against any possible contingency of loss or damage. 

Resolved, That it is the sense of this meeting that the management 



34 MEDICAL SOCIETY OF NEW JERSEY. 

their interest, but would cast an undeserved stigma upon the office of 
the Surgeon -General of the Army. 

Resolved^ That we again respectfully petition Congress to provide 
suitable annual appropriations for the increase and preservation of 
the museum and library, and also for carrying on the valuable Index 
Catalogue of the Surgeon-General's office. 

Resolved, That a committee of three be appointed by the President 
of this Society to prepare suitable memorial, which shall be printed 
and sent to each of our representatives in Congress. 

Drs. B. A. Watson, H. G. Taylor and E. M. Hunt 
were appointed as the Committee. 

The report of Committee on Lunacy was read by Dr. 
Parrish, and on motion of Dr. Benjamin was adopted. 
(See Appendix.) 

On motion of Dr. Hunt the committee was continued, 
and was requested to extend its services in behalf of the 
Society to the Council of State Charities and Correction 
appointed by the Governor of the State. 

The Committee on Treasurer's Report reported that 
it had examined the accounts of* the Treasurer, and had 
found them to be in accord with the Treasurer's report. 
The Committee recommends that the assessment of the 
District Societies for the next year ht^%\,^o per capita. 
(See Appendix.) The report and the recommendation 
as to the assessment were, on motion, adopted. 

The Committee on Honorary Membership reported 
favorably of the nominations of Dr. Isaac E. Taylor and 
T. A. Emmett, of New York, for honorary membership. 
A ballot was taken, and both were declared elected. 

Dr. Kipp. Third Vice-President, read an essay on " The 
Prevention and Treatment of Purulent Conjunctivitis." 

Dr. G. T. Welch followed with an essay on " Many 
Drugs: Few Remedies." 

The thanks of the Society were, on motion of Dr. 



MINUTES. 35 

Chandler, voted to both for their papers, and copies of 
the same were requested for publication. 

On motion, it was resolved that the attention of the 
State Board of Health be called to the contagion of 
ophthalmia, which can be guarded against by circulars of 
instruction to families. 

The Committee on Honorary Membership reappointed 
for the three years. 

The present Business Committee reappointed. 

Business Committee reported paper by Dr. Ill, by title, 
" Several Cases of Ovariotomy," which was, on motion, 
referred to Committee on Publication. 

Drs. O'Hare and W. B. Ulrich, delegates from the 
Medical Society of Pennsylvania, being formerly pre- 
sented, appropriately responded in behalf of their 
Society. 

The following was received : 

To the Honorable PresidetU and Secretary of the New Jersey State Medical Society, 
in session at Cape May Cify, June lo, 1884 .* 

We, the undersigned, physicians of Cape May County, would re- 
spectfully request that a charter for the organization of a District 
Medical Society for the County of Cape May be granted at the present 
session of your Society. 

Virgil M. D. Macey, 
James Mecray, Jr., 
Isaac M. Downs, 
Henry H. Kennedy, 
James H. Ingram, 
George C. Carll, 
Randolph Marshall, 
W. S. Leaming. 

On motion of Dr. Parrish the petition was granted, and 
the President and Secretary were instructed to issue the 
cor^ * accordance with the By-Laws, 



36 MEDICAL SOCIETY OF NEW JERSEY. 

The Nominating Committee would respectfully present 
the following report, and recommend for 

President — Dr. P. C. Barker. 
First Vice-President — Dr. Joseph Parrish. 
Second " — Dr. Chas. J. Kipp. 

TAird '* —Dr. John W. Ward. 

Secretary —Dr, Wm. Pierson. 
Corresponding Secretary — Dr. Wm. Elmer, Jr. 
Treasurer — Dr. Wm. W. L. Phillips. 

Standing Committee — Drs. T. J. Smith, E. J. Marsh, D. C. 
English. 

Delegates to American Medical Association — J. H. Pugh, J. W. 
Snowden, J. H. Love, Wm. Perry Watson, H. C. Clark, Wm. Elmer, 
D. B. Ingersoll, D. C. English, J. E. Avrison, Wm. Pierson, A. W. 
Rodgers, Quintori Gibbon, W. H. Merril, J. W. Paul and J. M. Beam. 
Delegates to Medical Society of Pennsylvania — T. R. Varick, 
Joseph Parrish, E. S. Busby. 

Delegates to Medical Society of Connecticut — N. Williamson, H. G. 
Buckingham, C. R. Wiley. 

Delegates to Medical Society of Rhode Island — H. H. James, E. H. 
Reily, M. Able. ^ 

Delegates co Medical Society of Massachusetts — E. M. Hunt, H. 
M. Weeks, P. A. Harris. 

Delegates to Medical Society of Maine — J. H. Griffith, Edward 
North, J. L. Bodine. 

Delegates to Medical Society of Vermont — D. M. Forman, P. Hoff- 
man, D. Benjamin. 

Delegates to Medical Society of Delaware — G. T. Welch, W. H. 
Amos, E. Oliphant. 

Delegates to Medical Society of New York — Jos. S. Green, D. B. 
Ingersoll, J. S. Whitaker. 

Delegates to British Medical Association and International Medi- 
cal Congress — E. M. Hunt, I. N. Quimby, S. S. Clark. 
Member of Fellows' Prize Essay Committee — Wm. Perry Watson. 
Place of meeting. Long Branch, with the recommendation that the 
Committee of Arrangement have power to change the place of meet- 
ing in case of an emergency. 

The report was accepted. 



MINUTES. 37 

The officers and members of the Fellows' Prize Essay 
Committee were elected by ballot, the Secretary acting as 
teller. The delegates were appointed by a viva voce vote. 

The recommendation as to place for the next annual 
meeting was accepted. 

It was voted that the time of the meeting be the 
second Tuesday in June, 1885, at four o'clock P. M. 

Dr. H, H. James, of Rahway, was appointed Essayist 
for the next meeting of the Society. 

The following bills were ordered to be paid : 



S. Toombs, 
Wm. Pierson, 
Wm. Elmer. 
CJ.Kipp, - 
T. J. Smith. 
J. Parrish, - 



53 



Fellows' Prize Essay Committee: Drs. S. Wickes, W. 
P. Watson and E. M. Hunt. 

The Committee was instructed to select a subject for 
the essay at its earliest convenience, and to publish it in 
the Medical Press. 

The Standing Committee was, on motion, made the 
Committee on Publication, and was given the usual dis- 
cretionary power in regard to the publication of the 
papers referred to it, and also as to the number of copies 
of the Transactions it will publish. 



38 MEDICAL SOCIETY OF NEW JERSEY. 

It was voted that delegates to American Medical 
Association and to corresponding societies have power to 
appoint their own alternates, providing they shall be a 
member of a District Society of this State. 

On motion, it was 

Resolved, That a vote of thanks be extended to the officers of the 
West Jersey Railroad Company ; to Mr. McClellan, the proprietor of 
the Stockton Hotel ; to the Mayor and citizens of Cape May, for their 
generous hospitality and courtesy to the members of this Society, and 
to the Committee of Arrangements for their efforts to further the 
interests of the meeting. 

Resolved, That the Secretary be instructed to inform the parties 
interested of the passage of these resolutions. 

The President appointed the following Committee of 

Arrangements for the next annual meeting: S. H. Hunt, 

H. R. Baldwin, D. M. Forman, W. H. Shipps, Henry 

Mitchel. 

Adjourned. 

WILLIAM PIERSON, 

^ Recording Secretary, 



APPENDIX TO THE MINUTES. 



[APPENDIX No. I.] 

Treasurer's Report. 

To the Medical Society of the State of New Jersey : 

The Treasurer begs leave to present the following statement of the 
financial condition of the Society : 

Receipts from all sources, as follows : 

Bergen $30 00 

Hudson 60 00 

Burlington 46 50 

Hunterdon 27 00 

Warren 25 50 

Passaic T 64 50 

Atlantic 25 50 

Essex 1 53 00 

Somerset 19 50 

Sussex 39 00 

Morris 49 50 

Monmouth 45 00 

Mercer 64 00 

Gloucester 20 50 

Middlesex 27 00 

Cumberland 27 00 

Camden 55 50 

Union % 55 50 

Diplomas 30 00 

Interest 62 00 

1 hand 88 59 

$1,055 09 



40 MEDICAL SOCIETY OF NEW JERSEY. 

The following have been the disbursements : 

C. J. Kipp $4 50 

S. Toombs 6 00 

W. Pierson 14 50 

W. Elmer, Jr 8 48 

C. J. Kipp 759 33 

$792 81 
Balance on hand |>262 19 

Assets : 

U. S. 4 per cent. Bonds $1,550 00 

In Savings Bank 182 81 

Total $1,732. 81 

WM. W. L. PHILLIPS, 
June 10, 1883. Treasurer. 



[APPENDIX No. II.] 

Report of Committee on Treasurer's Accounts. 

The Committee on Treasurer's Accounts would respectfully report 
that they have examined the Treasurer's accounts and audited the 
same, and find them correct, as follows : 

U. S. 4 per cent. Coupon Bonds, at par value $i,55o 00 

Amount in Newark Savings Bank 182 81 

Cash on hand 88 59 

$1,821 40 

Receipts from all sources, 1883, as follows : 

Balance from 1 882 $88 59 

From District Societies 904 41 

Interest on U. S. 4 per cent. Bonds 62 00 

$1,055 <^ 



APPENDIX TO THE MINUTES. 4I 

Disbursements : 

Paid as per vouchers ... 792 81 



Balance $262 19 

The Committee recommend that the assessment of the District 
Societies be $1 . 50 fer capita. 

L. W. OAKLEY, 
H. GENET TAYLOR, 
H. M. WEEKS, 
• Committee. 



[APPENDIX NO. III.] 



Report of Corresponding Secretary. 



The Corresponding Secretary would respectfully report : 

The duties incumbent upon the office during the past year have 
been duly fulfilled. A copy of the Transactions has been forwarded 
to each honorary member, and the usual exchanges effected with 
other State Societies. 

In return. Transactions have been received from the following State 
Medical Societies : Maine, New Hampshire, Massachusetts, Connecti- 
cut, Pennsylvania, Delaware, Maryland, Virginia. South Carolina, 
Georgia, Mississippi, Louisiana, Texas, Tennessee, Ohio, Indiana, 
Illinois, Michigan, Wisconsin, Minnesota, Arkansas, Colorado, Cali- 
fornia and Oregon. Also from the New York Academy of Medicine, 
and from the College of Physicians and Surgeons, Philadelphia. 

A copy of the " Report on Preliminary Education," as presented by 
the committee — Drs. Pennington, Elmer, Jr., and Rogers — at the last 
meeting of the Society, was forwarded to the American Medical 
Association at its recent session in Washington^ with the following 
letter to the Secretary, Dr. Wm. B. Atkinson : 



42 MEDICAL SOCIETV OF NEW JERSEY. 

Office of Corresponding Secretary, ) 
N. J State Medical Society. s 

Trenton, N. J., May 7th, 1884. 
Dear Doctor : 

I herewith forward to you a copy of the " Report on Preliminary 
Education," prepared by the committee and presented to the Society 
of the State of New Jersey at its annual meeting in 1883. It was 
then ordered to be printed, and will come before the Society at its 
ensuing meeting in June next for adoption. 

As it coincides with the suggestions made by your President — 
Austin Flint — in his address, will you present it to the Association, 
that it- may receive therefrom its sanction and approval, as requested 
in recommendation fourth, page 6. 

Yours very truly, 

Wm. Elmer, Jr., ' 

Cor, Secy N. y. State Med. Society, 

To Wm. B. Atkinson, M. D., 

Secy Am. Med. Association. 

In reply, the Secretary informs me that the communication was 
presented, formally received and ordered to be spread upon the min- 
utes, but no special action was taken upon it. 

There is no business requiring the attention of the Society. 

W. ELMER, Jr.. 

Corresponding Secretary. 
Trenton, N. J., June 9th, 1884. 



[APPENDIX No. IV.] 

Report of Committee on Honorary Members. 

Gentlemen of the State Medical Society : 

The Committee to whom was referred the names of Dr. Thomas 

A. Emmet, of New York City, and Dr. Isaac E. Taylor, of the. same 

place, as candidates for an election to an Honorary Membership of 

this Society, would respectfully report favorably, and recommend their 

election. 

HENRY R. BALDWIN, 

S. W. PENNINGTON. 

E. M. HUNT. 
Cape May, June 10, 1884. 



APPENDIX TO THE MINUTES. 43 

[APPENDIX No. v.] 

Report of Committee on Army Medical Museum 
AND Library of Surgeon-General's Office. 

Mr, President and Gentlemen of the New Jersey Medical Society : 

I have the honor to report that early in the present session of Con- 
gress the following bill was introduced in the House and in the 
Senate, and was referred to the Committees on Public Buildings and 
Grounds of those bodies respectively : 

[IV. Copy of a bill reported to the Committee on Public Buildings 
and Grounds, to the House of Representatives, in the 2d Session 
of the 47th Congress, February 28th, 1883. (H. R. 7681.)] 

" A bill authorizing the erection of a fire-proof building in the City 
of Washington to contain the records, library and museum of the 
Army Medical Department. 

" Be it enacted by the Sfenate and House of Representatives of the 
United States of America in Congress assembled, that the erection of 
a brick and metal fire-proof building, to be used for the safe keeping 
of the records, library and museum of the Surgeon-General's Office 
of the United States Army, is hereby authorized to be constructed 
upon the government reservation in the City of Washington in the 
vicinity of the National Museum and the Smithsonian Institution, on 
a site to be selected by a commission composed of the Architect of 
the Capitol, the Secretary of the Smithsonian Institution, and the 
officer jn charge of the State, War and Navy Department building, in 
accordance with plans and specifications submitted by the Surgeon- 
General of the Army, and approved by said commission, the cost of 
the building, when completed, not to exceed the sum of two hundred 
thousand dollars ; the building to be erected and the money expended 
under the direction and superintendence of the officer in charge of the 
State, War and Navy Department building." 

No report has yet been made by either Committee, but it is under- 
stood that the Committee of the Senate, of which Senator Mahbne, 
of Virginia, is Chairman, is satisfied as to the desirability of providing 
such a fire-proof building, and is prepared to report the bill favorably 
to the Senate. In the House Committee, the matter has been 



44 MEDICAL SOCIETY OF NEW JERSEY. 

referred to a special sub- committee, consisting of Mr. Stocksloger, of 
Indiana ; Mr. Young, of Tennessee, and Mr. Milligan, of Maine. So 
far as can be learned, there is no special or definite opposition to the 
bill, nor does any member of the Committee deny the propriety and 
necessity of providing such a fire-proof building ; nevertheless, no 
action has been taken. What the reasons are for this unfortunate 
and unwarrantable delay, it has not been possible to ascertain. 

The fifth volume of the Index Catalogue is nearly completed, and 
estimates have been submitted to Congress for funds for proceeding 
with Volume VI, which estimates it is believed will be granted, 
together with those for the support of the Museum and Library. 

It will be seen that the over-crowded and dangerous condition of 
the building in which the Library and Museum are now stored is still 
without a remedy by Congress, and that the difficulties in the way of 
obtaining proper provision for these national treasures are due more 
to apathy and indifference than to any special opposition. Under 
these circumstances, the physicians of the country should take steps 
to convince members of Congress that this is a matter in which they 
are specially interested, and expect their representatives also to take 
an active interest. Therefore, your Committee respectfully present 
the following preamble and resolutions : 

Whereas, It is the opinion of the Medical Society of New Jersey 
that the Army Medical Museum and the Library of the Surgeon- 
General's Office, at Washington, D. C, have been largely instrumental 
in the advancement of sound professional and scientific knowledge, 
and that they give promise of still greater usefulness in the future ; 
and 

Whereas, It is learned witji regret that both these collections are 
in great jeopardy from fire or accident through the insecurity and 
unsuitableness of the building in which they are stored ; it is 

Resolved, That Congress be respectfully urged to provide suitable, 
indestructible quarters for these invaluable treasures, to secure them 
against any possible contingency of loss or damage. 

Resolved, That it is the sense of this meeting that the management 
of these national collections has been eminently successful in the 
past, and that any change of administration would not only be 
injurious to these interests, but would cast an undeserved stigma 
upon the office of the Surgeon-General of the Army. 

Resolved, That we again respectfully petition Congress to provide 
suitable annual appropriations for the increase and preservation of the 
Museum and Library, and also for carrying on the valuable Index 
Catalogue of the Surgeon-General's Office, 



APPENDIX TO THE MINUTES. 45 

Resolved, That a committee of three be appointed by the Chairman 
of this Society to prepare a suitable memorial, which shall be printed 
and sent to each of our representatives in Congress. 

B. A. WATSON, 

H. GENET TAYLOR, 

E. M. HUNT, 

Committee, 



[APPENDIX No. VI.] 

Report of the Committee on Lunacy. 

• 

Before commencing the work assigned to them, your Committee 
deemed it both wise and courteous to communicate with the State 
Board of Health, whose functions are somewhat of the same nature 
with those assigned to your Committee, hoping that such counsel or 
co-operation as might aid us in our inquiries might be afforded. 

In response to our communication, the Secretary of the Board gave 
notice that it was his intention, in company with the Governor of the 
State, to make an official visit to the alms-houses of the several 
counties. This was accompanied by the recommendation to post- 
pone any visitations on the part of your Committee till after the 
publication of the report of said Board. 

Regarding such action by the Governor and the Secretary of the 
Board as possibly covering the entire field contemplated by your 
Committee, we were glad to await the publication of the report 
referred to, contenting ourselves with the issuance of a circular con- 
taining thirty-five questions — as to the number of insane patients 
under care ; the methods of restraint, if any ; the manner of treat- 
ment as to exercise and employment ; the number of deaths, autop- 
sies, etc. A large number of the officers to whom these inquiries 
were addressed responded promptly, and from these answers we are 
enabled to collate and present to you the information following. 

The report of the Board of Health came to hand but a few weeks 
since, and we find that though it does not, to any considerable extent, 
take cognizance of the condition of the insane poor of the State, it 
presents some facts which confirm the observations of your Com- 
mittee that are presented herewith. 



46 MEDICAL SOCIETY OF NEW JERSEY. 

It is stated that the physicians employed by the counties to visit the 
alms-houses once a week, or oftener if necessary, are not in any sense 
alienists ; and we may add that the compensation they receive does 
not warrant them in taking the time from their regular practice suffi- 
cient to acquaint themselves with this specialty, so that the profes- 
sional care given to the insane poor in the county-houses of New 
Jersey amounts simply to nothing, so far as scientific inquiry and 
treatment are concerned. Dr. Ezra Hunt says in his report that 
** neglects are so common as not to be regarded as neglects," and 
that " the solitary confinement of insane patients is the rule, and 
individual study the exception." 

Such a state of things may not be so much the fault of the profes- 
sion as it is of the Chosen Freeholders, who are the recognized legis- 
lators for the counties. It seems to be their function to do as little 
for the helpless as possibly can be done, and to 'pay as little as possi- 
bly can be afforded as compensation, at all, to those who would if 
they could make insanity a study, and thus be prepared to render 
practical service to this most dependent and supplicating class of our 
fellow-citizens. 

It is also apparent that mechanical restraints are yet employed in 
some places, and that very imperfect attention is given to any method 
that may make the use of wristlets, camesoles, anklets, etc., ever a 
necessity. The day has already come when such appliances should 
be abandoned ; and it may not be long when they will not be known 
in New Jersey, except as relics of an age of darkness concerning the 
therapeutics of insanity. 

The bathing accommodations, with few exceptions, are inadequate 
to the wants of the patients. Buckets of water, carried to the apart- 
ments, are all the provision that is made in some institutions. In 
others there are bath rooms, and some more attention is given to this 
matter of personal hygiene. 

As to the food administered, it can all be summed up in the simple 
itxm— poor -house diet. No special diet is appropriated to the insane. 

The great radical question of occupation and 'amusement does not 
seem to have been thought of in the majority of cases, and yet it is 
true, as all alienists know, that this is among the most important 
matters to consider in connection with the whole subject. In no 
instance is there a library, unless it be in the city institutions in the 
northern part of the State. 



APPENDIX TO THE MINUTES. 47 

The question, How many are under medical treatment ? is answered 
without exception, none, unless, indeed, it be for some other malady 
than the one for which they are committed. 

The number of reported cures is seven. Not a single autopsy of 
the brain has been made. 

Among the county-houses heard from, they do not possess suitable 
instruments of precision for studying, either in the living or dead sub- 
ject, mental pathology. The ophthalmoscope and microscope, so 
essential for such investigations, are unknown instruments. There 
is among all the houses, one clinical thermometer and one galvanic 
battery^ Test tubes and chemicals for urinary analysis are not to be 
found as the property of a single institution. 

No record is kept of the history, symptoms, changes in condition, 
modes of treatment or causes of death, with one exception. 

In a few instances, religious services are held on the Sabbath, 
which all may attend who desire to. 

In the light of humanity, it is a sad reflection that to-day there are 
hundreds of our fellow-men in the county-houses of this State in 
whom the light of reason has been extinguished, and who in their 
helplessness are found as beneficiaries of the public bounty, who are 
simply moping away their days in a semi-dreaming state, or in a state 
of absolute demention, or of some more acute demonstrative form of 
mental alienatien. 

In the light of public duty and of our common fraternity, it is a 
sad thought that our public authorities seem to possess no adequate 
conception of what we owe, as active aud intelligent citizens, to those 
of our kind who are helpless and suppliant at our very doors, for we 
certainly owe them more than mere shelter, food and raiment. 

In the light of our honorable profession, the sense of reproach and 
condemnation is added to that of regret and sadness, which should 
be felt by the community at large, by reason of the existence of such 
facts as the brief and hasty investigation of your Committee has 
revealed. 

Cases of individual privation and unremitting restraints, of filth and 
seclusion, of utterly insufficient building accommodations, etc., are 
omitted from this report, your Committee preferring to offer 
general facts, with a glance at the whole field, than to portray in- 
stances of personal neglects and injury, with the hope that the interest 
of the profession may be awakened to urge upon the State and 



48 MEDICAL SOCIETY OF NEW JERSEY. 

county authorities the necessity for prompt and radical reform in the 
conduct of our county-house system, at least so far as the insane are 
concerned. 

We have no right to say that the treatipent of chronic insane, with 
reference to their improvement or cure, is needless, and that all that 
is requisite is to make them physically comfortable: Physical comfort 
cannot be had without exercise in the open air ; and nothing is more 
conducive of the destruction of mental integ^ty than the perpetual 
ennui and introversion of a solitary life. 

Go into the insane wards of our county-houses, and day by day, 
and every day, we find these conditions — listlessness, indolence, mut- 
terings, and increasing physical infirmity. With no amusements — 
nothing to allure and compose the mind, it clings to its own delusions, 
feeds upon its own fancies, and becomes its own destroyer. 

Whoever has the power to compel physical exercise in such cases, 
and to induce and captivate the lingering but fading intelligence, and 
does not do it, is measureably responsible for the continuance of the 
sad condition that we call incurable— chronic insanity. 

In closing this report, your Committee would notice the law passed 
in 1883, providing for " A Council of State Charities and Corrections," 
which is intended to cover the same field of inquiry and inspection 
as that proposed by this Society, in the appointment of its Committee 
on Lunacy. The names of the persons appointed by the Governor 
who now constitute this new Board, are as follows : Jesse H. Deverty, 
of Cape May ; Benjamin Edge, of Jersey City ; Robert A. Haley, of 
Paterson ; Henry Fredericks, of Camden ; Lawrence Farrell, of New- 
ton ; William J. Throckmorton, of Freehold. 

By the provisions of this act, sub-counsel may be appointed in each 
county, of one or two persons, who shall be authorized to fulfil the 
functions of the Board for the precinct in which they reside. 

Provision is also made that the officers of all institutions shall keep 
an exact register, in a form to be prescribed by the council, of all the 
inmates of the several places, which will secure uniformity in the 
returns and enable the council to determine important questions con- 
nected with the history and concern of inmates, and of treatment and 
results in the several corrections and curative institutions. 

Your Committee deeply regret their inability to present a more 
complete report, but with the time and material at their command, 
they have prepared what they now have the pleasure to offer as their 



APPENDIX TO THE MINUTES. 49 

report, with the recommendation to adopt the following preamble and 
resolutions : 

Whereas, The Legislature of the Sate of New Jersey having, at 
its session of 1883, passed an Act entitled " An Act to Create a 
Council of State Charities and Correction," it is deemed of sufficient 
importance to the health and well being of the people as to call for 
congratulations by the Medical Society of New Jersey ; therefore. 

Resolved, That the Medical Society of New Jersey, in annual meet- 
ing assembled at Cape May, June 10 and 11. 1884, welcome the 
appointment by the Governor of the State of a Council of State 
Charities and Correction, as an additional and co-operative factor 
with this Medical Society in correcting the neglects and abuses to 
which the insane poor of the Commonwealth are subjected, especially 
in the county alms-houses throughout the State. 

Resolved, That in congratulating the community upon the existence 
of such a Council, the Medical Society of the State, the District 
Societies in the different counties, and individual physicians in their 
respective homes, will cheerfully co-operate with said Council, in all 
suitable and legitimate plans, to secure the result contemplated by 
law. 

Resolved, That the Corresponding Secretary be instructed to trans- 
mit to said Council a copy of these resolutions, with a copy also of 
the Transactions of this annual meeting, when they shall be published. 

JOSEPH PARRISH, 
L. W. OAKLEY, 
WM. PIERSON, 
ED. MARSH, 
FRANKLIN GAUNTT. 



[APPENDIX No. VII.] 

report of the delegate to the american 

Medical Association. 

Mr. President and Gentlemen of the Medical Society of New Jersey: 
As one of the delegates from the Medical Society of New Jersey to 
the American Medical Association, I have the honor to submit the 
following report : 

In company with Drs. D. Benjamin, Joseph Parrish, W. B. Watson, 

Geo. Bayles, Geo. T. Welch, L. A. A. Allen, H. W. Elmer, of the 

State Society ; Drs. B. Reed, Wm. H. Ireland, Alex. Moray and others 

of the County Societies, I attended the thirty-fifth annual meeting of 

4 



go MEDICAL SOCIETY OF NEW JERSEY. 

that Association, held in the City of Washington, on May 6, 7, 8 and 
9, 1884. 

This meeting was, by the unanimous consent of those members 
who had attended and were familiar with the former meetings of that 
Association, of equal if not of greater excellence, for many reasons, 
than that of any other meeting which had preceded it. Because of 
the great number of members present ; because of the cordial greet- 
ing of the very efficient Committee of Arrangements, and of the most 
excellent accommodations furnished for holding the general sessions, 
and for the several sections of the Society ; and because of the 
President's address— one of the most masterly productions perhaps 
ever presented to a medical society ; and of the papers rich in erudi- 
tion, read upon the various subjects before the meetings, and before 
the several sections ; and because of the universal sociability mani- 
fested among its ' members, and the cordial sympathy and generous 
courtesy extended to the Association by the President of the United 
States, the Surgeon-General and Staff of the United States Army, the 
Chief Justice of the United States, the Commissioner of Pensions and 
staff, and by many of the most prominent citizens of our nation's 
capital. 

It would be entirely out of place for me at this time to state at 
length the proceedings of the meeting. They have already been 
published in part in the journal of the Association ; and as the several 
papers read will be published from time to time in that journal during 
the ensuing year. But I can but make mention briefly of some 
points which your delegates consider not of the least value. I refer, 
first, to the prominence of this meeting and the estimation in which 
it is held by men of eminence, composed as it was of men from all 
parts of the Union, and embracing in its numbers some of the great- 
est medical lights of the nation — of the world. Here Maine greeted 
Texas, and Florida grasped the hand of Oregon. Here existed no 
Mason and Dixie line, nor was sectional feeling known ; but brother 
met brother on the common level, and no distinction prevailed, save 
that of the greater excellence in our beloved profession. 

The President of the United States opened his doors and bid us 
enter. Then taking each of us by the hand, greeted us as friend 
greets friend. The distinguished head of the judicial department of 
our nation — Morrison R. Waite — received us with the warmest cor- 
diality, and then presented us to his wife and family. With the same 



APPENDIX TO THE MINUTES. Si 

cordiality were we greeted by the presiding officers of Congress. 
These, I repeat, with the illumination of the Capitol at the instance of 
our visit, the illumination of the Corcoran Art Gallery, the reception 
by Mr. Corcoran and of the trustees of that finest collection of 
paintings and sculpture in the United States, all speak in unmistakable 
language of the estimation in which our Society — our profession, is 
held by men of State and ability. 

The address of welcome by Dr. A. Y. P. Garnett, of Washington ; 
the address of the venerable President— Dr. Austin Flint, as well as 
the various papers read before the Society and the several sections 
were, as before intimated, of unusual merit. But as they are now 
being published in the journal in their entirety, mere mention is at 
this time made of them. 

The meeting was harmonious throughout. Scarcely a ripple dis- 
turbed even the surface of the placid waters ; arid only in a few 
instances was this ripple manifested ; and when manifested, it was 
caused by an honest difference of opinion of how the greater excel- 
lence of the profession might be obtained, both in medical literature 
and practice. < 

The Society is officered by efficient men. Dr. H. T. Campbell, of 
Georgia, being its President, and the very efficient Secretary, Dr. 
Atkinson, was re-elected. New Jersey, I am not sorry to say, is 
scarcely represented in the list of officers. Nor need we be surprised 
at this ; for when we consider that your delegates went to represent 
the Medical Society of New Jersey — the oldest society in the Union 
— a society which is not only distinguished by her age, but by her 
purity— her constant and firm adherence to the tenets of our profes- 
sion — we cease to wonder why this is so, for the delegates were 
actuated by a far nxore noble purpose than to seek office and conse- 
quent apparent notoriety, their purpose being to represent the Society 
of New Jersey in all the pure principles taught^ by that Society ; and 
this purpose they fully carried out. And earnest and eloquent were 
the appeals of Benjamin, Quimby and others, for regulations that 
would secure to all greater proficiency in the healing art. 

The next session of the Association will be held in New Orleans at 

the usual time. We confidently predict that the American Medical 

Association is destined to be one of the strongest towers of medical 

ablility into which not only the profession in our own beloved country 

may find security, but that into which that of the world shall flee to 

find refuge. 

D. B. INGERSOLL. 



52 MEDICAL SOCIETY OF NEW JERSEY. 

[APPENDIX No. VIII.] 

Report of Delegate to the Medical Society of 

THE State of Pennsylvania. 

To the Medical Society of the State of New Jersey : 

As your delegate to the Medical Society of the State of Pennsyl- 
vania, I would report that I had the pleasure of attending that Society 
at its last meeting, held in Philadelphia. 

The Association possesses among its membership many able pro- 
fessors and distinguished medical authorities, consequently the papers 
presented were not only numerous but of a very high character. 

One of the most striking features of this Association is the large 
number of lady physicians present, and one of the most scientific 
papers read was by a very brilliant young lady — Alice Burnett, M. D. 
As the papers will be easily reached through the Transactions, it will 
be unnecessary to give a detailed account of them. 

There was a committee appointed to draft a plan to elevate the 
standing of medical diplomas. 

The members and delegates were entertained in the most elegant 
manner. 

June loth, 1884. D. BENJAMIN. 



[APPENDIX No. IX.] 

Report of Delegate to the Connecticut State 

Medical Society. 

To the Medical Society of New Jersey : 

In obedience to your appointment, your delegate attended the 
ninety-third annual meeting of the Connecticut Medickl Society, held 
at New Haven, May 28th and 29th, 1884. 

Regretting exceedingly that our Society had no representative at 
our sister Society's meeting last year, because of the inability of my- 
self and fellow-delegates to attend, and knowing that we had not had 
the pleasure of welcoming any delegates from that honored Society 
since 1872, I resolved, as you had honored me with an appointment to 
the same Society this year, that I would, though at some personal 



APPENDIX TO THE MINUTES. 53 

inconvenience, attend and set our Connecticut brethren a good exam- 
ple, and assure them of our earnest desire that the fraternal relations 
existing between us in former years should be renewed and perpetu- 
ated from year to year. Your delegate (the only one of the three 
app(^nted who attended) was very cordially received and courteously 
entertained. 

The annual convention of the Connecticut Society (consisting of 
five Fellows elected from each of the eight County Societies, the 
President, Vice-President, Treasurer and Secretary, and Committee 
on Matters of Professional Interest in the State, elected at the pre- 
vious annual meeting, and the Presidents of the County Societies, 
who are Vice-Presidents ex-officio of the State Society — in all about 
fifty-five members), meets annually in Hartford and New Haven 
alternately. One feature of their meetings impressed your delegate 
very favorably — nearly all of the routine business was transacted dur- 
ing the first day, in a session lasting from three to six o'clock, P. M. 
The second day's exercises consisted of : the report of the Secretary ; 
the annual address, by President E. B. Nye, of Middletown, on " The 
Medical Profession and its Claims to the Respect and Gratitude of 
the Community " ; the report of the Committee on Matters of Pro- 
fessional Interest ;* the reception of delegates from other societies, 
and the reports of delegates to other societies ; dissertation on " The 
Germ theory of Disease " ; exhibition and description of three surgi- 
cal cases successfully operated upon — one of litholoplaxy, one of 
extirpation of a large portion of the tongue affected with cancerous 
disease (the lingual arteries having first been ligated and a tracheal 
tube inserted), and the other of hip-joint disease with great flexion of 
thigh, entirely relieved with one inch shortening of leg ; essays on 
*' Medicine Fifty Years Ago," " Seventy-five Cases of Conjunctivitis," 
" Important Points in Strangulated Hernia," " The Early Diagnosis 
and Treatment of Pott's Disease of the Spine." Several voluntary 
papers were also presented and read by title. The annual address 
and the papers generally were able and interesting, brief discussions 
of some of them following their reading. At one o'clock the Society 
adjourned to partake of the annual dinner, which concluded this 
entertaining and instructive session of the Society. At this bountiful 
and much-enjoyed feast, your delegate suffered the penalty attached 
to the honor of representing the oldest of the sisterhood of medical 
societies by being called upon to follow such distinguished speakers 



54 MEDICAL SOCIETY OF NEW JERSEY. 

as the Honorable Mayor of the city and the venerable President 
Porter, of Yale. Our only consolation, as we think of our effort, is 
that as we followed them so far off and our response was brief, our 
lack of ability as a post-prandial speaker was not so conspicuous, and 
our hope is that it will result in securing the renewal of the friendly 
intercourse between these two time-honored societies. 

Your delegate desires to add that his visit to the beautiful City of 
Elms, the cordiality of his reception by the Connecticut Society, and 
all the incidents connected therewith, will long remain in pleasing 
remembrance. 

Respectfully submitted, 

DAVID C. ENGLISH. 

New Brunswick, June 9th, 1884. 



[APPENDIX X.] 

Report of the Delegate to the Massachusetts 

Medical Society. 

Of the delegates elected to attend the Massachusetts Medical 
Society, only the undersigned was present. The meeting of the 
Society was held in Boston, in Huntington Hall, in the Institute of 
Technology, on Wednesday, June nth, 1884. I arrived in Boston 
Monday night the 9th inst. I owe much of the pleasure of my visit 
to Professor George G. Hopkins, of Brooklyn, N. Y., a delegate from 
New York. I was an entire stranger; he took me in charge, and 
showed me much of the city that I should not have seen had I not 
met him. A very good programme was arranged for the Fellows 
and Delegates to the Society for Tuesday the loth. All the hospitals 
and medical school buildings were thrown open for our inspection. 
I visited the Massachusetts General Hospital, and witnessed an opera- 
tion by Dr. Warren, for knock-knee, caused by a curvature of the 
tibia. The bone was cut subcutaneously with a chisel, about one 
inch below the knee-joint ; straightened, put in a posterior tin splint, 
and dressed with antiseptic dressing. 

I also saw Dr. Henry Bigelow, the fa* otripsy, operate for 



APPENDIX TO THE MINUTES. 55 

the removal of a stone from the bladder. In his hands it seemed a 
very simple and easily-performed operation. He operates very rapidly, 
and seems to know where his instrument is and what it is doing as 
well as if it were before his eyes. 

I also visited the new Harvard Medical School Building. It is a 
very fine building, fitted up with all the modem improvements for 
teaching. Professor H. P. Bowditch demonstrated the methods of 
instruction and research in physiology. He showed the effects of 
irritation on the vagus nerve on the blood pressure ; the pressure 
being greater when the nerve was irritated. Professor Thomas 
Dwight showed the modem methods of teaching anatomy. He 
showed various frozen sections of the body, and thin sections of bone, 
illustrating their structure. He demonstrated the working of the 
semi-lunar valves, and proved them to be perfect valves. Many other 
things of interest were shown and described that would make this 
report too long for me to speak of. 

At three o'clock, P. M., in Huntington Hall, Dr. G. W. Gay, of 
Boston, Surgeon to the City Hospital, read a paper on the *' Posterior 
Plaster Splint in Fractures of the Leg," illustrating the same with 
cases, and applying the splint before the meeting. He claims for it 
ease of application and immediate application, not having to wait for 
swelling to come up or go down, perfect adaptability to the parts, and 
an impossibility of displacing the fracture when once properly 
dressed. His manner of applying the splint is, first, to cover the leg 
with a roller bandage made of sheet wadding or canton flannel— two 
thicknesses, then a piece of crinoline is cut to encircle the leg from 
the toes to above the knee, leaving a space along the front of the 
limb of half an inch. Using this as a pattern, eight or ten pieces are 
cut, the outer one two inches larger than the other. The plaster is 
now mixed with water to a proper consistency, and rubbed into the 
crinoline, one layer at a time. The edges of the outside piece are now 
turned in over the others, and it is applied to the limb, and encircled 
with a roller bandage, which is removed as soon as the plaster sets. 
It is particularly valuable in treating children, as it cannot be dis- 
placed, will not strangulate the limb, is comfortable, and admits of 
easy inspection. 

An adjourned meeting of the Society was held at four o'clock, P.M. 
After ^* ercises of opening the meeting were through, a 

r : females be admitted as fellows on the same 



56 MEDICAL SOCIETY OF NEW JERSEY. 

terms as males. After a very animated and somewhat excited dis- 
cussion, the motion was carried by a vote of two to one. In the 
evening the councillors concurred in the motion by a vote of sixty- 
three to forty-seven ; and at the one hundred and fourth annual 
meeting of the Massachusetts Medical Society females can become 
members. At five o'clock a collation was served in the New Har- 
vard Medical School Building. This day, although not the regular 
meeting of the Society, was very agreeably and profit ibly spent. 

Wednesday, June nth, at nine o'clock, A. M., the one hundred and 
third Annual Meeting of the Society was called to order by the 
President, Dr. Alfred Hosmer, of Watertown. There was a large 
attendance. A very noticeable feature was the preponderance of old 
men; more than one-half of the fellows present had passed their 
three score years. After the preliminary exercises, there were several 
very interesting papers read. Dr. F. Nickerson, of Lowell, read a 
paper on " Chylous Deposit in the Abdomen," with the history of a 
very interesting case : a man, aged forty-five years, previously healthy, 
was attacked suddenly with pain in the abdomen, followed by swell- 
ing of the same. Upon examination, a well-defined tumor was dis- 
covered in the lower part of the abdomen. This was aspirated and 
two quarts of a milky fluid withdrawn, which, by chemical examina- 
tion, proved to be chyle. At different times during two years, similar 
attacks took place, when he would vomit and pass from the bowels 
the same milky fluid. It is now one year and a half since the last 
attack, and he is believed to be perfectly well. The sudden attack, 
its long duration, the great loss of chyle and the perfect recovery, 
makes the case particularly interesting. 

Dr. L. Huntress, of Lowell, read a paper on ** The Pitch of the 
Percussion Sound." He dwelt upon the importance of pitch in diag- 
nosis. He mentioned some of the different conditions upon which 
pitch depends, viz. : the covering of the chest (clothing), inspiration 
and expiration, the volume of air contained in cavities, the tension of 
the chest (walls), the connection of a bronchial tube with a cavity. 
He also said that the pitch was different on the two sides of a healthy 
person, and difference in pitch did not necessarily mean disease. He 
drew his conclusions from the study of two hundred cases. 

Dr. J. F. Adams, of Pittsfield, read a paper on " Sanitary Forest 
Culture." He claimed that trees are productive of health, by equali- 
zing the moisture of the ground and atmosphere. The roots and 



APPENDIX TO THE MINUTES. 57 

shade prevent the rapid evaporation of water from the ground. 
Also, that where forests abound the temperature is modified and 
milder. Where trees have been cut off, malarial diseases have pre- 
vailed that were never known there before. He cited several places 
where this had occurred ; and in the discussion that followed, several 
of the Fellows substantiated his position by citing cases that had 
come under their personal knowledge. 

Dr. J. Seaverns, of Roxbury, read a paper on ** Weight as an Indi- 
cation of the Character of Risks for Life Insurance." Taking the 
standard of weight adopted by the life insurance companies, and 
allowing twenty per cent, above and below as they do, the Doctor 
claimed was not right, and the rate should be fifteen per cent, below 
the standard and twenty-five above. Outside of these latitudes it was 
dangerous to accept risks. The paper was based upon the study of a 
large number of deaths, and it would be well for all physicians who 
examine risks for life insurance to read the paper. 

The annual address was delivered by Dr, John Curwell, of Haver- 
hill. He urged the need of educating the public in sanitary science 
and hygiene. He spoke of the manner of American cooking, con- 
demning it, and advised that we take lessons of the French. He 
spoke of the contagious diseases — the manner in which they were 
allowed to spread and the mode .of prevention, and closed with an 
appeal for trained nurses, the better feeding of infants and educating 
the poorer classes. 

The annual dinner was served in the skating rink on Clarenden 
street, eight hundred Fellows being present. Dr. George Shattuck, 
the anniversary Chairman, made a few very appropriate remarks, and 
introduced the new President, Dr. Homans, who, in his remarks, said 
the Society had increased from 68 Fellows in 1789 to 1,520 in 1884, 
and he thought if the same rate of increase kept up, that the Society 
would be somewhat larger than now at the end of the next hundred 
years. 

Governor Robinson was introduced and received with hearty cheers. 
He made some humorous remarks. Said he had no fear of being 
among so many M. D.'s as long as he kept his mouth shut. He con- 
gratulated the Society upon the action taken the day before in admit- 
ting females. He spoke of the duty of the physician to his patient 
and to the State. He welcomed the Society, in the name of the Com- 
monwealth, and wished it a prosperous future. 



58 MEDICAL SOCIETY OF NEW JERSEY. 

Remarks were made by the retiring President, Dr. Hosmer ; Dr. 
Curwell, Rev. Mr. Courtney and Mr. Justice Field and others, when 
the Society adjourned, better and happier for this meeting and dinner, 
as all men, and especially doctors, are happier when they have a full 
stomach. 

EDWARD NORTH, M. D. 



PRESIDENTS DISCOURSE. 



Living and Dying — their Physics and Psychics. 

Life is an infinite mystery. The genesis of life is 
obscure only to the theophobiac and so, agnostic. It is 
written with the pen of iron, and with the point of a 
diamond, in the rock forever. The revelations of science, 
acknowledged and incontrovertible, are in harmony with 
the sublime record of the inspired historian, " These are 
the generations of the heavens and the earth.*' We note 
the azoic rocks, the vegetable fossils, the protozoa and 
the higher orders of animal life through the illimitable 
periods of creative energy, and after these were made, 
on the " sixth day " man was created — not made or built 
up — evolved from vitalized units already existing and 
adjusted by chance. He became, by an Almighty fiat^ a 
living soul, made a little lower than God,* to have 
dominion. 

His normal state when created and before he fell was 
deathless. His physical constitution was complete, and 
its vital functions were perfect. Without liability to pain 
or sickness or any sorrow, and it may be to any thing 
which we call decay, he was designed by the Creator to 
live out his destined period of existence here, and when 
the time was fully come to be translated to another and 
higher state of being. There is no meaning in the words. 

• Rev. Ver. 



6o MEDICAL SOCIETY OF NEW JERSEY. 

of the great Apostle when he speaks of the redemption 
of the body — the I,G)ua — corpus y if he does not refer to its 
restoration from the effects of the fall. By man came 
death. " He was, so to speak, the procuring cause of the 
penalty of death. If it had not been so, the removal of 
the conditions necessary to life in the mortal state would 
ipso facto translate him to the immortal." Its restored 
immortality is brought to light in the death and resur- 
rection of the second Adam. 

Only from the days of the flood is it true that the lives 
of men in general were reduced to about the present 
limits, for after the times of Moses and Joshua few 
instances of prolonged life are recorded. Moses, who first 
committed to writing divine revelation, says, " The days 
of our years are three score years and ten, and if by 
reason of strength they be fourscore years yet is their 
strength (breadth) labor and sorrow." He wrote of 
human life as it then was. 

We cannot solve the problem of the prolonged lives, of 
men before the flood. They retained health and vigor of 
body through many centuries, and, so far as we know 
their history, we have no intimation that sickness was 
known. The only record is, they died ; and this may 
have been the result of natural decay. We know that at 
the exodus from Egypt, notwithstanding the grinding 
bondage under which the Israelites had lived, there was 
not one feeble person among their tribes. They were 
accoutred and marshalled as an army of 600,000 fighting 
men ; none " stumbled from weakness," or were unfit for 
the line of march. 

Were these remarkable facts concerning those who 
lived before the flood, and of those who lived 800 years 
after, the result of a concurrence of natural causes pro- 



LIVING AND DYING. 6t 

videntially created, their employments, their diet, their 
heredity? Neither revelation nor our limited knowledge 
of cosmical and telluric forces give us the answer. Even 
now physiologists and naturalists are not agreed upon 
the normal period of human life. The changes in the 
organism and the conditions most favorable to longevity 
are but partially understood. Sterne says, that " At 
sixty years of age the human tenement gets fast out of 
repair, and the lodger with anxiety thinks of a dis- 
charge." Haller and Buffon assert that after the most 
careful researches into the physiological laws of the 
duration of the human life, lOO years is the period 
Providence has allotted to man. Haller collected a great 
number of examples of long life. He claims to have 
found more than one thousand instances of persons who 
had reached the age of from lOO to no years; sixty of 
those from no to 120; twenty-nine of 120 to 130; fifteen 
of 130 to 140; six of 140 to 150, and one of 152 years, 
read of by all of us, old Dr. Parr, who died in the reign 
of Charles I. Such instances as these were made from 
traditional sources, and none of them investigated with 
that careful research which is necessary to establish their 
verity. When we consider the loose methods of estab- 
lishing the dates of birth, the identity of names appearing 
in successive parish and other records, and the readiness 
of the popular mind to accept the wonderful, Haller's 
data cannot be accepted as authentic. 

Roger Bacon, in his treatise on the " Secrets of Nature 
and Art," says that " every man would be able to remedy 
his own decay if he would subject his health from youth 
up to a complete regimen, embracing food, drink, sleep, 
waking, motion, rest, evacuation, constriction, climate, 
and habit of mind. For if any one would follow these 
rules from birth, he would live as long as that nature 



62 MEDICAL SOCIETY OF NEW JERSEY. 

derived from his parents would permit, and would reach 
the extreme limit of that nature which has fallen from 
original righteousness ; but he could not transcend this, 
for this regimen hath no remedy against the corruption 
of our first parents/' And "at first," he further says, 
"when the life of man began to shorten, the remedy 
would have been easy, but now it is difficult for the cure 
to be provided after 6,000 years and more. Yet the wise, 
moved by the aforesaid considerations, know how to de- 
vise means not only against the defects of any special 
remedy, but against the corruption of our first parents, 
not so that man be brought back to the life of Adam, in- 
asmnch as the causes of decline are so strong — but that 
life may be prolonged a hundred years or more beyond 
the common age of man now living/* The speculations 
of this old philosopher of the 13th century are not with- 
out their force. Remove all causes of bodily disease, as 
he quaintly puts it, out of food, drink, sleep, waking, 
motion, evacuation, constriction, climate, and habit of 
mind and body. Let the influences of such a condition 
exert their power for one hundred generations and then 
imagine their effect upon a thousand generations more, 
and who can reasonably doubt that the human constitu- 
tion, if left to the operation of natural causes, would be 
brought to a vigor and power- of resisting decay and to 
that freedom from disease which we suppose to have pre- 
vailed before the days of Noah. Is it unreasonable to 
suppose that the doctrines of Bacon may yet, in a 
measure, be realized in the future history of the race, and 
that the causes of decline which have been in operation 
for 6,000 years, and may be for many times that period 
more, are, at some period in the future, to give place to 
causes of renovation and a restoration to something of 
antediluvian vigor in that long millenial day which is to 



LIVING AND DYING. 63 

shine upon our fallen but^then partially regenerated earth. 
At the end of 6,000 years, we are only upon the thresh- 
old of this world's history. It gives no evidence of wear- 
ing out or of decay in any direction. We are apt to solve 
our problems of natural processes in the light of a life 
bounded by fourscore years, not remembering that the 
destiny of this world is in the hands of One with whom 
" one day is as a thousand years." 

Considering man as he now is, the most distinguished 
physiologists of our own day are agreed in the opinion 
that threescore years and ten are the average, and one 
hundred years is the extreme limit of the life pf man. In 
the English civil law, the legal presumption of life ceases 
at the expiration of this period from the date of birth, 
and the same rule is adopted in Scotland. These legal 
propositions are in accord with the researches of modern 
naturalists and physiologists. Buffon says " the man 
whose life is not cut short by accident or disease reaches 
everywhere the age of ninety or one hundred years." He 
further remarks: " If we consider that the European, the 
Negro, the Chinese, the American, the man highly civil- 
ized, the savage, the rich, the poor, the inhabitant of the 
city and the dweller in the country, so different one from 
the other in every other respect, agree in this one point, 
and have the same interval of time to run through twixt 
the cradle and the grave, that the differences of race, of 
climate, of food, of comforts, make no difference in the 
duration of life, it will be seen at once that the duration 
of life depends neither upon habits and customs, nor the 
quality of food, that nothing can change the fixed laws 
which regulate the number of our years." The " fixed 
law " to which he alludes is, that in the animal economy, 
not in man only, the duration of life is regulated by the 



64 MEDICAL SOCIETY OF NEW JERSEY. 

duration of growth. " Man," he says, " grows in height 
till he is i6 or i8, but his size is not developed until 
he is 30. Dogs attain their full length during the first 
year, but it is only in the second they reach their 
full bulk. Man, which is 14 years in growing, lives six or 
seven times- that period, while the horse, of which the 
growth is completed in four years, lives six or seven times 
that period. Flourens claims that the one certain sign 
that growth has been completed is found in the union of 
the bones with their epiphyses. Until the bones are thus 
united the animal continues to grow ; when this union 
takes place growth ceases. In man this union occurs at 
20, in the camel at 8, horse at 5, ox at 4, lion at 4, dog at 
2. He further says that an animal lives five times his 
period of growth. Thus, man being twenty years in 
growing, lives five times twenty, one hundred years." 
This is the physiological limit as adopted by Buffon and 
Flourens. 

The records of life assurance in England give emphatic 
evidence of the extreme rarity of centenarianism. These 
companies have existed in Great Britain since 1706, and 
down to 1872 there has been but one policy-holder who 
has died at 100 years of age, one in his looth year, and 
three in their 99th year. (Vid Note A in Supplement.) 

Whatever may be our speculations or our physiological 
conclusions in regard to the history of death in relation 
to the human race, we cannot shut our eyes to the sober 
reality that it is now its early inheritance. The varied 
circumstances under which the medical man is led to 
contemplate it, in its approach and its conquest over 
every age and condition, render it to him, independent of 
subjective thoughts, an event of deep scientific interest. 
The physician is led to feel, with reference to his patient, 



LIVING AND DYING. 65 

and his patient's friends that he stands, so to speak, at the 
gateway of the sepulchre. It is of great moment that his 
appreciation of the indications of approaching dissolution 
should be so intelligent that he may not, on the one hand, 
alarm by exaggerating morbid phenomena, while he intel- 
ligently discovers and warns of the onset of fatal symp- 
toms on the other. 

We have before said that man was made with a perfect 
and immortal body. Having a moral nature and placed 
under law, he was capable of choosing good or evil. He 
chose the evil and became subject to death. The earth 
had been made beauteous for him and to bring forth, 
spontaneously, all that was necessary for his highest good, 
but the thorns and briars of the ground became tokens to 
him that it was cursed for his sake and that in sorrow and 
in the sweat of his face he should eat bread. The latent 
germs in the earth of noxious growths betokened the 
germs of disease and decay and of the final corruption of 
the body, which should return to the dust out of which 
it was taken.**^ 

The hearty the lungs and the brai7i are the three vital 
centres at which death may be said to begin. We have 
the distinctive character of death beginning at the heart 
in the loss of blood from sudden hemorrhage. The circu- 
lation fails, not because the great central organ has lost 
its powers of contraction, but because the blood does not 



♦ On the third creative day the earth was made to bring forth grass and herb and 
tree whose seed was in itself a/ier Us Hnd. The definition of the Hebrew word 
ZRA, translated seed, is something "sown, scattered, universally diffused, every- 
where implanted " as a germ in the earth. That it does not mean the seed of a 
plant or tree appears from the fact that plants and trees producing seed had not 
yet appeared on the earth. The translation is "whose germinal principle of life, 
each in itself after its kind, is upon the earth." And so in disease germs, the 
primordial principle of life awaits those conditions of environment necessary to 
develop them. — {Lifit its True Genesis, — Wiigkt.) 

6 



66 MEDICAL SOCIETY OF NEW JERSEY. 

reach its cavities in sufficient quantities. The order in 
which death takes place in the different organs is as fol- 
lows (we quote from Dunglison) : " The heart failing to 
propel its blood, the encephalon and gray matter of the 
medulla spinalis no longer receives the necessary impulse 
for the continuance of their functions ; they cease to act. 
The consequence of this is the death of all those organs 
which receive their nervous influence from them. All 
voluntary motion is annihilated, as well as the action of 
the respiratory and other reflex muscles. The mechanical 
phenomena of respiration are consequently arrested and 
the air is no longer received into the chest. From this 
cause then the chemical phenomena of respiration would 
cease, were they not previously rendered unnecessary by 
the cessation of the heart's action. The phenomena of 
nutrition, secretion and calorification, functions connected 
with the intermediate system, yield last." This train of 
influences may occur suddenly, as by the rupture of an 
aneurism, or flooding in childbed, opening of large vessels 
on the field of battle, &c., producing syncope ; or by a 
more gradual process in a failure of the contractile power 
of the heart. The manifestations of this mode of dying 
are faintness and paleness of countenance, the lips white 
and trembling, the breathing oppressed ; cold sweats, 
dimness of vision, vertigo and dilated pupils are followed 
by a general restlessness, a weak, wavering pulse, and 
speedy dissolution. When death comes by asthenia from 
disease, the processes are somewhat modified. The pulse 
becomes feeble and frequent and the debility extreme, 
but the senses are perfect and the mind clear to the last. 
These phenomena are very manifest in acute peritonitis, 
malignant cholera and fatal gangrene. Exhausting dis- 
ease which gradually interferes with the nutrition of the 



LIVING AND DYING. 6/ 

body acts in the same manner, as in phthisis, dysentery, 
or long-continued drains upon the system. 

Death beginning in a failure of the respiration is known 
as asphyxia or apnoea, a ttvpw, absence of breath. En. 
trance of air into the lungs may be prevented by stoppage 
of the mouth and nostrils, by submersion in liquids or 
gases containing no oxygen, by mechanical obstructions in 
the larynx and trachea, or by strangulation ; by forcible 
pressure arresting the motions of the chest and diaphragm, 
by paralysis of the muscles of respiration, by injury of 
the upper part of the spinal cord, or by the admission of 
air into the cavity of the thorax and by filling the plurae 
with liquid. These causes all lead to the same result, 
viz : the chemical alteration of the blood in the capillaries 
of the lung, and in the distribution of the venous blood 
throughout the circulation, thus poisoning unto death. 

The following symptoms are manifested when the 
occlusion of air is sudden and complete. Strong but vain 
contractions occur of all the respiratory muscles and 
struggling efforts to get breath. The agony of this con- 
dition is very short. This is followed by vertigo, then 
loss of consciousness and convulsions. All efforts soon 
cease in dissolution. During the process, the face, at first 
flushed and turgid, becomes livid and purplish, the veins 
of the head and neck swell and the eyeballs seem to pro- 
trude from their sockets. At length the heart ceases its 
action and life is extinct. Sudden death by apnoea, as 
above described, is not often witnessed as the result of 
disease. But there are numerous forms of diseases in 
which the tendency to death by apnoea is very marked. 
We have all seen more or less of these distressing symp- 
toms in cases of false membranes in the larynx and 
trachea, pulmonary apoplexy, and in the pneumonia of 
children. 



^ MEDICAL SOCIETY OF NEW JERSEV. 

remains to notice the mode of dying beginning in 
t:he nervous renf,.«o n ^ / & s & 

«a centres. L.oma and stupor more or less pro- 

f oun are the result of morbid states of the brain. The 

*,ensonal functions ce^e to act. Respiration continues, 

t>u It becomes more and more irregular and laborious and 

y ceases. The order of death (to quote again from 

punghson) is, *^the interruption of the brain's action 

destroys, first, that of the voluntary, and secondly, that 

o e mixed muscles. The mechanical phenomena of 

respiration therefore cease, and then the chemical. This 

is followed by a cessation of the heart's action. To the 

cessation of the heart's action succeeds the loss of the 

general circulation, and then that of the functions of 

nutrition, secretion and calorification." 

1-he study of the different modes by which death 
makes its onset is of the highest practical importance. 
In some diseases — fevers, for example — it becomes neces- 
sary to watch the varied tendencies they may assume ; 
and the safety of the patient is often due to the careful 
skill by which they are arrested. The disease may 
threaten to prove fatal by coma. When the lungs are 
involved, suffocation is threatened ; and, then again, 
deficient nutrition threatens syncope. A tendency to a 
partitular form of death will prevail in and characterize a 
whole epidemic. It is by the timely aid afforded by the 
watchful and intelligent physician that in these grave 
cases the machinery of life is kept in motion. 

We now approach another branch of our subject of 
peculiar interest to the medical man — the evidences or 
signs of impending dissolution. The prognosis, in most 
of the cases under his care, has revealed to his mind their 
probable result, and the signs which nature gives out that 
its powers are about to cease their struggle do not take 



LIVING AND DYING. 69 

him unawares. An accurate appreciation of them, how- 
ever, becomes necessary to his own calm and decided, yet 
gentle and sympathizing deportment amid the tumultuous 
and excited anxieties which manifest themselves around 
the bed of the sick and dying loved one. 

One of the earliest presages of approaching dissolution 
is a general restlessness. The patient, who has lain quiet 
and exhausted heretofore, suddenly becomes uneasy and 
tosses from side to side. Sometimes he raises himself 
and throws his body forward — is intolerant of the bed 
clothing; and, in cases of obstructed respiration, tears 
open the covering of the chest. At times a desire is 
expressed to get up and dress and leave the sick chamber. 
We saw a child a few, weeks since, ten years of age, who, 
less than an hour before his death, insisted upon getting 
up and taking a bath. Chomel notices, as of serious 
import, the automatic manner in which a patient persist- 
ently draws his hand to his side in spite of the efforts of 
his physician to feel his pulse. In cases of fever, a per- 
sistent sliding down in the bed was first noticed by Dr. 
Mitchell, of Philadelphia, as a fatal sign, and it has been 
verified by all observers since he pointed it out. Catch- 
ing at imaginary objects and picking of the bedclothes 
is well understood as a fatal presage ; sometimes, while 
the eye is fixed on a portion of the coverlid, and vacantly 
gazing upon it, the fingers begin to pick and fumble it ; 
at other times, while the eyes are closed or fixed on the 
wall, the hand and fingers are at work upon the bed- 
clothes. We have at times noticed repeated efforts to 
lay out and smooth the covering, or, if a handkerchief is 
at hand, to raise it up square by the corners and lay it 
down and smooth it out, repeating the movement over 
and over again. Frequent calling for drink, with a 
hurridd grasping of the cup and a rapid swallowing of its 



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LIVING AND DYING. 7 1 

eye ; yet many of those which are usually regarded as 
conclusive of death require a' rigid scrutiny, and it is not' 
infrequently invited on the part of friends whose fears of 
vivi-sepulture call for a careful survey of the existing 
phenomena. The most obvious fact which is presented 
upon the event of death, is the total cessation of every 
power and faculty and function of the body. It lies 
prone and utterly powerless. The lungs which have 
regularly and continuously performed their office have 
ceased to act. The heart has ceased its beating, and the 
blood, which has coursed • 

* * * * " through 

The natural gates and alleys of the body," 

has ceased its flow. It has settled in red and blueish 
spots on the more dependant parts of the body. The 
eye is now a dull and sightless ball. The features 
are relaxed, and the jaw is fallen. The heat of the 
surface is passing away, and all that is embraced in 
the fearful word dead stands out to the view of the 
beholder. In a short time — usually in about seven hours, 
though sometimes not till twenty or thirty hours — rigidity 
of the limbs takes place. When the body is wasted by 
disease, this comes on sooner. It may occur in an hour. 
Its duration also varies, from two or three days to a 
longer period, according to atmospheric warmth and 
humidity. The cooling of the surface seems to depend 
upon external temperature and the disease of which the 
patient has died. According to an accurate observer, the 
average time is about fifteen or sixteen hours, when not 
much clad and in a temperature of about 60^ F. In 
cases of death by cholera, the body previously of an icy 
coldness, becomes warm immediately before and after 
death. 



72 MEDICAL SOCIETY OF NEW JERSEY. 

The body now deprived of its vitality, the processes of 
Corruption are at once set' up. The indication first 
noticed is a discoloration of the abdomen. This, by 
most observers, is considered an infallible sign of death. 
It sometimes appears very early. I have often seen it on 
the second day. A corpse exposed to a warm tempera- 
ture will show this sign in half a day. It is said to be 
earlier manifested in females than in males, and in deaths 
from acute abdominal inflammations, dropsies, etc. The 
seat of this discoloration is said, by a recent writer, to be 
sub-epidermic and, under the microscope, to be composed 
of green granules resembling the minute structure of 
vegetable mould. With these signs present to our senses, 
there can be no fear of premature burial. The SwjLta is 
here ; the "^vxtj is in the realms beyond. (Vid Note B.) 

Is the act of dying a painful one ? Why should it be. 
We are not necessarily born to suffering. All natural 
conditions (with the exception of child-bearing) are, 
more or less, sources of pleasure. Our physiological 
nature is such that the last phenomena in natural death 
are the same as those of sleep. The latter depends on a 
failure of the sensitive functions. The difference between 
sleep and the act of dying is, that one is temporary and 
the other is for all time.* Scripture language is very 
significant on this point : " Thou turnest man to destruc- 
tion. * * * A thousand years are as a watch 
in the night, -Jt * * ^j^^y ^re as a sleep '* — as 
short as the hours spent in sound slumber appear to be 
on awakening — Ps. xc : 5 ; " Now shall I sleep in the 
dust '* — Job vii : 23 ; Those " that sleep in the dust shall 
awake " — Dan. xii : 2 ; At the resurrection of our Lord, 



* Philip on Death. 



LIVING AND DYING. 73 

" many bodies {iLoifiara — corpora) of the saints which 

slept arose " — Matt, xxvii : 52. 

When the first man fell asleep he is supposed by Milton 

to have, in a confused way, identified the sensation with 

that of dissolution. Death was then unknown — above 

conception, because beyond experience. But, equally so 

was sleep ; and Milton's supposition is in accordance 

with what we would assume as Adam*s actual feelings. 

On a green, shady bank, profuse of flowers, he seats him 

down, 

" Then gentle sleep 

First found me and with soft oppression seized 

My drowsy sense, untroubled, tho' I thoii|^ht 

I was passing to my former state 

Insensible, and forthwith to dissolve." 

c 

The death by nature — true euthanasia — is illustrated in 
one who dies at the close of a long decline of years. The 
vital powers fail in detail. The senses are sealed in suc- 
cession. Sight becomes dim, the hearing gradually fails, 
the touch is no longer acute, odors make little impres- 
sion, and the taste is blunted. So the organs of waste 
and the functions of the brain gradually fade out. The 
memory fails, the judgment is unsettled, the muscles 
grow feeble, the ligaments become stiff, and the spring 
and force of life disappear.* 

At' last, the intellectual man reduced to the instinctive, 
the consummation is longed for, and without pain or a 
struggle or knowledge of the coming event, the deep 
sleep that falls is the sleep that knows no waking till the 
Resurrection morn.f 

The approaches to death are usually through the pains 
and sufferings of disease ; and in the study of the act of 



• Papillon. 
t Richardson. 



74 MEDICAL SOCIETY OF NEW JERSEY. 

dying, we must distinguish between it and the distress 
caused by the disease which precedes it. It is not an 
ordinance of nature that death should be cruel or painful 
to the mind ; nor is it ordained that it should be cruel or 
painful to the body. We are born without suffering — 
sleeping into existence and awaking into knowledge. 
When the physical life is ended, we " doze into sleep and 
sleep into death. "''*"f 

The great poet just quoted, in exalted strain describes 
an interview of the Archangel with our first parent, as he 
for the first time looked upon death in the cadaver of his 
son begotten^ of his loins. Adam says : 

" Have I seen death ? Is this the way 
I must return to dust ? O sight 
Of terror, foul and ugly to behold ! 
Horrid to think ! How horrible to feel ! " 

The heavenly visitant replies : 

" Death thou hast seen 
In his first shape in man ; but many shapes 
Of death, and many are the ways that lead 
To his grim cave, all dismal ; yet to sense 
More terrible at the entrance than within." 

The fear of death is universal. Says Burton : ** Timor 
mortis, morte pejor^ However holy the life, however 
strong the assurance of Christian hope, the fear of death 
abides. Good old Sir John Brown quaintly says: ^' I fear 
to die ; I am not afraid when I am dead.":|: 



* •' If I had strength enough to hold a pen," said Sir William Hunter, " I 
would write how easy and delightful it is to die." 

t Richardson. 

X We make a distinction between the fear of death and fear in dying, as will 
appear hereafter. 



LIVING AND DYING. 75 

The ancients erected propitiatory altars to disease, and 
to all the evils of life, and acknowledged the tranquility 
of death. They dedicated their sepulchral monuments 
jEternali Somno, 

** Stretched in the dust the unhappy warrior lies, 
And sleep eternal seals his swimming eyes," 

• 

is Homer^s description of the death of one of his heroes. 
The Greeks styled their burial places Kotfiijrijptoi — ccBmeter- 
turn — the sleeping-room. The Hebrews, with other Eastern 
nations, represented death by terms calculated to mitigate 
the appalling image inspired by the last enemy. They 
called it a journey or departure. They compared it to a 
sleep and to rest, after the toils of life. It was a com- 
mon expression to say of the deceased, he has gone or is 
gathered to his fathers or to his people. Their minds, 
unenlightened concerning the future, were schooled to 
look upon death in a pleasing light, and the universal 
thought was, objectively, in this direction. The obtrusive 
thoughts of the event, as a subjective experience, were 
carefully excluded. The Romans would not speak of 
death, but paraphrased the name — decessit e vita. They 
did not say that one has died, but that he has lived — 
vixit. Even in the middle ages, in the old Latin chroni- 
cles, when they speak of kings and of the distinguished 
dead, the fatal word was avoided. Transire a sceculo — 
vitam suam mutare were the terms employed.* 

The inscriptions on the tombs of the early Christians, 
in the Roman catacombs, seem to bear evidence of an 
entire absence of terror. They are those of peace, rest, 
felicity. They lived amid persecutions and martyrdoms, 
and when the gospel had filled the hearts of believers 
with the hope of an eternal life of joy, death was an 

* Curios, of L. 



7^ MEDICAL SOCIETY OF NEW JERSEY. 

occasion of rejoicing rather than of sorrow to the friends 
of the departed. Early Christian art and symbolism, 
both in the paintings of the catacombs and in the mosa- 
ics of the first churches, were nowhere suggestive of 
gloom or dread. The very cross was wreathed with 
flowers and adorned with palms. The sepulture of the 
primitive Christians, so many of them martyrs, was 
memorialized in the historic paintings by what is noble 
and exalted. Their minds, occupied with the recompense 
awaiting them after their fierce trials and often dreadful 
death, they saw from these a happy release into a state of 
everlasting peace.* 

When the Christian faith was established in Europe, 
and the church had become corrupt, the belief in a future 
retribution took possession of the minds of the people, 
and a dread of death took the place of the more com- 
forting contemplations of the earlier Christians, in view 
of the future. Then it was that the people saw the 
*^ grave yawn and death in the gothic form of a gaunt 
anatomy parading through the universe. The people 
were frightened as they everywhere saw hung before 
their eyes, in the twilight of their cathedrals and their 
* pale cloisters,' the skeleton and other most revolting 
emblems of death. "f 

We are thus led to believe that in all the past, as it 
now is, the calm and unexcited thought of death is 
mingled with fear. The mind shrinks from it as an 
enemy. Divine revelation declares it to be " the last 
enemy." We said the unexcited thought of death, for 
excitement and pre-occupation of mind annihilates all 
fear. This is manifested on the field of battle, amid its 
scenes of death and carnage. At. the battle of Fort 

* Monumental Christianity, 
t Curios, of Lit, 



LIVING AND DYING. ^^ 

Donaldson, in our late war, a company was detailed, as 
the color company, to bear the standard and plant it 
within the works of the enemy. The bearer of it became 
at once the target for hostile shots ; and as one bearer 
fell the standard was taken by the next, and then again 
by another, till all but seven of the company were shot 
down. Excitement and a mind preoccupied led to a 
willing and certain slaughter, while to each of the victims 
the announcement in the quiet of his home that death 
was at the door would have caused dread and terror. A 
recent writer upon this subject remarks : " In regard to 
human kind, the Supreme Wisdom has confined the 
direct terror of actual death to or near the moment of 
death. There is little antecedent pain or mental suffer- 
ing respecting the act ; so little that we say, when we see 
in any man an undue fear of death, we call him a hypo- 
chondriac. At the worst in the natural growth of mind, 
the period of existence in which the dread of death is 
intensely developed, is a period embracing, in the major- 
ity of persons, the mere third of the term of existence. 
In the very young, they have in articulo mortis no more 
dread of death than of sleep. In the adolescent there is 
such a rapid aggregation of force — call it life — that they 
think of death to the last as to them impossible. In the 
old, the dread which may have marked a transitional 
stage from prime strength to first weakness, the terror is 
allayed by lesser care for that which is, and by that 
curious mental process, so persistent that it seems to pro- 
ceed from beyond us, of binding the mind to the inevit- 
able so gradually and so slowly that the progress towards 
the final result becomes endurable, and even happy."* 
We cannot truly realize that state of mind, in the near 



^Dr.B. W. Richardson on M. 6* D, 



78 MEDICAL SOCIETY OF NEW JERSEY. 

prospect of death, of one who feels the divinity which 
stirs within him, and to whom the future is all dark and 
uncertain. The great English poet gives expression to 
this dread uncertainty in Hamlet's soliloquy — 

" Who would fardels bear 
To grunt and sweat under a weary life ; 
But that the dread of something after death — 
The undiscovered country from whose bourne 
No traveller returns, puzzles the will, 
And makes us rather bear the ills we have 
Than fly to others that we know not of ? " 

In the near, as also in the more remote prospect of 
death, the mind cherishes a concern for the body. It is 
not only the channel for the delights of sense, but is, in 
itself, pleasing to us and attracts our loving care. The 
aged patriarch gave directions before he died that he 
should be buried with his fathers. His touching language 
is expressive of the universal human wish, as to the 
disposition of the body : ** There they buried Abraham 
and Sarah his wife ; there they buried Jsaac and Rebekah 
his wife, and there I buried Leah." The uncounted 
millions of their mummied dead bear witness, through 
all the generations since, to this care of the Egyptians, 
though they knew nothing of the resurrection. The 
great apostle to the nations, whose inspired pen wrote of 
the body sown in corruption and raised in incorruption, 
speaks of the expectancy of the creature, as he waits in 
hope for the redemption of the body. It is a universal 
experience. Everyone is sensible of a wish that a care- 
ful disposition should be made of his mortal remains. It 
is not very uncommon that warm flannel clothing is pro- 
vided beforehand, that the body, when dead, should not 
be cold. I was once at the deathbed of a young woman 



LIVING AND DYING. 79 

who knew that she was dying, and after the last words of 
parting and affection had been uttered, said, " Now lay 
me straight.'* Homer causes his dying hero fainting at 
the approach of death to say : 

" Ah leave me not for Grecian dogs to tear ! 

The common rites of sepulture bestow 

To soothe a father and a mother's woe ; 

Let their large gifts procure an urn at least 

And Hector's body in his country rest." 

(Note C.) 

A state of perfect consciousness very often exists 
down to the very last moments of life, and long after the 
eye and the tongue have ceased to perform their office. 
A gentleman whose wife was about to die from the 
exhaustion of a protracted and complicated labor, said to 
her, while he could converse with her, that he would hold 
her hand when she was dying, and when she could not 
respond to his demonstrations of affection and sympathy 
by the usual methods, he would press her hand, and he 
wished her to return the pressure as a token of her recog- 
nition still. Long after speech was gone and every 
faculty of the mind seemed to be shaded in death, down 
to the last moment of respiration, she faintly returned 
the pressure of his hand. 

In cases of acute diseases attended with delirium, a 
resumption of the mental faculties occurs at the ap- 
proach of death. When the mental derangement is 
secondary and the cerebrum has not undergone patho- 
logical changes, it not infrequently completely subsides.* 
An unexpected and complete return of consciousness 
from apparent insensibility is observed in various classes 
of diseases — as in the deadly forms of fevers endemic in 
hot latitudes. A Greek physician — Aratceus — who flour- 

* La Roche. 



8o MEDICAL SOCIETY OF NEW JERSEY. 

ished about the middle of the first century of the Chris- 
tian era, and whose authority was scarcely inferior to that 
of Hippocrates, describing the first stage of causes or 
ardent fever, notes among the symptoms of the second 
stage a condition of delirium ; and that at the close of 
fatal cases and the approach of death, every sense be- 
came clear and the intellect acute.* 

In most cases, the act of dying is attended with 
delirium or a disturbance of the mental powers. Illu- 
sions of the mind, visions of objects animate and inani- 
mate, become manifest. Angels are seen hovering over 
the dying one ; the room is to them illuminated with an 
unearthly light, or bright stars are seen shining in sur- 
rounding darkness ; choirs of songsters singing and harp- 
ing heavenly music are heard. The English poet, in his 
famous ode, represents the angelic visitors ministering to 
the dying Christian in seraphic strains and in gentle 
whispers calling upon him to come away. It appears in 
other forms — as in a train of thought sometimes con- 
nected with old scenes, past pursuits or business. In 
those of quick sensibilities and ardent temperaments — 
in artists, for instance — as noticed by Papillon, ** there is 
a quick and sublime new burst of life in the creative 
genius." He refers to the angelic end of Beethoven, 
who, before he breathed out his soul, regained his lost 
speech and hearing, and spent them in repeating, for the 
last time, some of the sweet harmonies which he called 
his ** prayers to God." The last words of Dr. Armstrong 
were addressed to an imaginary patient, giving him direc- 
tions as to his regimen. An aged schoolmaster, as he 
v/as dying, said: "Boys, it is growing dark; the school is 
dismissed.** An English legal officer raised himself from 

* Ibid. 



LIVING AND DYING. 8 1 

his couch, and with the words " Gentlemen of the jury, 
you will find — /' fell back and expired. 

A state of mind is not uncommon where there seems 
to.be a quickening of the spiritual sense — the immortal 
part — to the appreciation of something not of earth, 
when it penetrates into scenes beyond the natural. 
Senator Foot, after lying quiet for half an hour before 
his death, suddenly lifted his hands and, with eyes now 
open and full of unearthly light, exclaimed : " I see it ! 
I see it ! The gates are wide open ! Beautiful ! Beau- 
tiful ! *' and almost immediately expired. Many illustra- 
tions of this kind might be given. (Vid Note D.) 

Far be it from me to discredit or depreciate the hope 
of the Christian believer and his happy, restful death ; 
nor dare we say that his eye cannot be quickened to have 
a momentary view of the mysteries beyond the mortal 
life. Saul, on his journey to Damascus, saw with his 
natural eye his glorified Lord ; and on a subsequent 
occasion he was caught up to Paradise and saw visions 
which were unutterable, whether in the body or out of 
the body he could not tell. The union of the body and 
the soul is a mystery. When sleep partially releases the 
soul from the fetters which bind it down to the mortal, 
who that analyses the operations of his mind has failed 
to recognize, at times, its enlarged scope and capacity in 
the higher realms of thought. When we see the bond 
finally and completely severed, we stand in the presence 
of a sublime mystery in silent wonder and reverent awe. 

The manifestations of the dying, such as we have 
described, belong to the natural. A recent writer 
remarking upon this subject* notes that in the anes- 
thaesia induced by chloroform, the visions similar to those 



* Spencer in Pop. Sci. M. 
6 



82 MEDICAL SOCIETY OF NEW JERSEY. 

immediately preceding death are experienced, and vary 
according to the temperament of the subject of them. 
It is not infrequent that beatific visions occur, and notices 
one patient who invariably, when under the influence 
of chloroform, sees angels hovering round her bed. The 
asphyxia caused by carbonic acid gas is attended with 
disturbed fancies similar to those attendant upon the act 
of dying, and doubtless in each case the result of carbon 
poisoning. 

The popular belief in the reality and significance of 
these phenomena is very strong, and the memory of 
them, when they do occur, is cherished by surviving 
friends as a source of perennial pleasure. No physician 
of any considerable experience has failed to observe 
them. They are sometimes of the most impressive 
nature and excite our deepest interest, but they give no 
new disclosures of the other world. The physiology of 
death teaches us that they are the clairvoyance of the 
dying, and are of no more significance than the clairvoy- 
ant dreams of the living. They are the signs which the 
reeling brain gives out of its own waste. The moral con- 
ditions in death usually correspond with those in life. 
(Note E.) ** God does not, in the final hour, work a 
miracle to improve upon the constitutional make which 
he gave us at the creation." * (Note F.) 

Divinity, law and medicine are distinguished from all 
others as the learned professions. Those who enter 
them are not attracted by the promise they give for the 
accumulation of wealth, nor do they foster an ambition 
to reach high civil distinction. A few in the ranks of 
each may secure both, but such prizes are not in the line 
of an earnest devotion to the higher purposes of any one 



Austin Phelps, 



LIVING AND DYING. 83 

of them. They are each a resultant of the higher needs 
of the race. If man had not fallen from the estate in. 
which he was created, none would have been called to 
proclaim redemption — none to study and adjust and 
regulate the laws of right and justice, in a world where 
the thoughts and purposes and acts of men were always 
conformed to a spontaneous and invariable acceptance of 
them ; and so the perfection and harmonious workings 
of our physical and psychical nature would have forever 
saved the human race from the pains, and sufferings, and 
diseases, and mortality of the body. The discussion of 
our subject cannot fail to impress us with the important 
and grave responsibilities assumed by the physician when 
he gives himself to his chosen life-work. Lord Bacon 
says : " Every man is a debtor to his profession.*' In 
each of the learned professions this is emphatically true, 
for their conscientious pursuit involves the fact that a 
debt is due to our fellow-men. Need I say that a pure 
personal character, a profound estimate of the claims of 
humanity, a loving sympathy with the sufferings of the 
sick and the most assiduous efforts to avert the dreaded 
event of death — more dreadful, oftentimes, to the living 
than to the departing — should distinguish the practitioner 
of the healing art. Our calling is not a mercenary one. 
The man who enters it with no higher conception of it 
than a business, fails to appreciate its claims upon him. 
Says a recent writer : " The physician who makes gold 
the chief end of his profe3sion, disgraces it.** We may 
add here, the community soon finds him out and esti- 
mates him accordingly. It is a calling which invites to 
mental application and to scholarly attainment. Nature 
reveals her secrets only to those who, by study, search 
for them in the wider fields of literature and science cog- 
nate to medicine* The subjection of her treasures to 



84 MEDICAL SOCIETY OF NEW JERSEY. 

his own use can alone secure the broadened intellect and 
the higher impulses of the learned physician. When, to 
all this, he cherishes a devout and abiding purpose to 
meet the claims of the God of nature upon his reverent 
personal service, he meets the claims of his profession, 
does good in his day, and commands the loving respect 
of his fellow-men. When such a life is finished, its 
memory is blessed. 

We have seen the fruitful overspreading tree against 
the cold, auroral-tinted sky of a winter's sunset. Its 
beauteous summer foliage withered and gone, its fruits 
all garnered ; but its graceful and harmonious outlines 
tell of its spring bloom, its summer beauty and its 
autumnal fruitage. It foretells, as well, its richer pro- 
ducts in the future. So is a finished life. Its fruitage is 
over, but its fragrant memories recall its outlines, full of 
grace and beauty, as they foretell the rewards in store for 
one who has served well his God and his fellow-man. 



SUPPLEMENT. 



NOTE A.— CENTENARIANISM. 

I 

William John Thorns, who wrote on " Longevity " (London, 1878), 
made a laborious and very thorough investigation of the cases of 
reputed centenarianism in England. His careful researches resulted 
in establishing the mythical character of them all, and the fact that 102 
or 103 years are the extremest age to be found in England, with but one 
or two of even that limit. He says : " After reading within a short 
period of the death of Ebenezer Baillie at 103, of Capt. McPherson 
at 100, of Betty Evans at 102, of Jno. Naylor at 117, of Sarah 
Edwards at 104, of Margaret Curtis at 103, of Sarah Pay at 104, of 
Sarah Jones at 108, of Sarah Clarke at 108, of Matthew Baden at 
106, of Richard Purser at 112 and Jacob Fournais at 135, of Jonathan 
Reeves (still living, 1873) at 105, of Wm. Webb of same age, of the 
parish officer of Chelsea Sending up in a balloon an old woman, Mrs. 
Hogg, to celebrate her loist birthday ; and of public entertainments to 
celebrate Susan Stevenson's looth birthday, and of public breakfasts 
to Capt. Lahrbush (of New York), to celebrate his 104th and 105th 
birthdays — after reading such announcements as these, and dozens of 
other similar notices, it seems almost an impertinence to doubt the 
accuracy of any of these statements, though there is scarcely one per 
cent, among these confident announcements which will bear the test 
of a thorough investigation." 

He then speaks of the difficulties of such investigations : the doubt 
cast upon statements of those who " know them to be true," but can- 
not make their knowledge plain ; the recklessness with which they 
are made without previous enquiry ; the blinding of the judgment 
by the love of the marvellous ; the known indifference of accuracy as 
to statements of facts and, notwithstanding the scepticism which pre- 
vails among medical men and others, " the simple, childlike faith 
with which men of the highest eminence in medical science accept, 
without doubt or hesitation, statements of the abnormal prolongation 



86 MEDICAL SOCIETY OF NEW JERSEY. 

of human life which startle plain matter-of-fact men, when their 
attention is called to them. Nay, not only receive these astonishing 
statements as if they were established, well-authenticated facts, but 
proceed to use them as premises from which to draw deductions still 
more startling." Mr. Thoms justifies this statement by a reference to 
an article on Longevity in the Edinburg Review, January, 1857, by 
Sir Henry Holland, who says : " At present it is enough to state that 
we have sufficient proof of the prolongation of life to periods* of from 
1 10 to 130 and 140 years — cases which, thus authenticated, we must 
necessarily take into view when dealing with the question of human 
longevity." 

Mr. Thoms declares that the statements of this distinguished writer 
are directly at variance with our daily experience, all our life tables 
and all the records of our insurance offices, and that a careful re- 
examination of the evidence on which they are based would demon- 
strate their utter worthlessness. 

Our author, inspired with the enthusiasm of his subject and recog- 
nizing the accuracy of the remark of Dr. Johnson, that " instances of 
long life are often related which those who hear them are more will- 
ing to credit than examine," undertook to investigate all the cases of 
prolonged life and published the results. As many of them have 
become historical and accepted as veritable, a notice of a few of those 
most remarkable is not inappropriate. 

THOMAS PAFfR. 

It is said of Parr that he was born at Winnington, in the parish of 
Alberburg, in the year 1483. In 1635 the Earl of Arundel, visiting 
his estates in Shropshire, " the report of this aged man (then reputed 
to be 152) was certified to him." He saw him and sent him, in a 
litter, to London, where he was presented to the king. In less than 
two months thereafter he died, and the celebrated post mortem 
examination was made by Harvey. Then the " old, old, very old " 
man was buried in the south transept of Westminster Abbey, where 
his gravestone records what doubtless, those who placed it there 
believed, that he had " lived in the reigns of ten kings." This record 
has no doubt contributed to perpetuate the popular belief in his 1 52 
years. 

An account of Parr is contained in the metrical life of him, by 
John Taylor, called the water poet, from his being a waterman, pub- 



LIVING AND DYING. 87 

lished in 1635. It does not appear upon what authority the definite 
statements as to the events of Parr's life, and the dates at which they 
occurred, were made. Probably the same report to which Harvey 
referred, or some printed sheet circulated at the time. These state- 
ments, our author says, are, under the circumstances of Parr's rank 
and condition of life, remarkable for their precision and minuteness. 
His endeavors, however, to discover the slightest corroboration of any 
one of the facts relating to old Parr, with the exception of his death 
in 1635, utterly failed in " bringing out a single scrap of evidence," 
notwithstanding his appeal to antiquaries, men of letters and clergy- 
men connected with Shropshire or interested in its history, and public 
and widely-circulated appeals for information upon the subject. He 
remarks upon the incredible story of the " old, old, very old man," 
that he does not know which is the most to be wondered at - " the 
exceptionally great age of 1 52 attributed to Parr, or to the fact that 
for upwards of two centuries no body has appeared to doubt its 
accuracy, or to have taken the slightest trouble to ascertain upon 
what evidence it is founded." 

Harvey's autopsy, so relied on and frequently alluded to, furnishes 
no evidence whatever of Parr's age. All he could say was, " It 
seemed not improbable that the common report was true," that he 
was convicted of bastardy after he passed his looth year. This 
opinion was formed from the condition of the organs of the body 
post mortem, 

• 

COUNTESS OF DESMOND. 

The inscription on her portrait at Muckross runs thus ' 

Catharine, Countess of Desmond, | as she appeared at ye court of 
our Souraign Lord King James in thys | present yeare, A. D. 16 14, | 
and in the 140th yeare of her age. Thither she came from Bristol to 
seek I Reliefe, ye House of Desmonde having been ruined by Attain- 
der. She was | married in ye Reigne of King Edward IV, and in 
ye course of her long | Pilgramage renewed her teeth twice. Her 
principal Residence is | Inchiquin, in Munster, whither she un- 
dauntedlye | proposeth (her Purpose accomplished) incontinentlie j 
to return. — "^Laus Deo (S. C.) 

Her husband was Thomas the twelfth Earl of Desmond, a grand- 
son of her great grandfather, James the seventh Earl, so that they 
were cousins-german, once removed. She was the second wife ; and 
as his first wife was living in 1 528, the marriage must have been sub- 



88 MEDICAL SOCIETY OF NEW JERSEY. 

sequent to that date, for Mr. Nichols shows most clearly (p. 60) that 
in 1528 — the twentieth of Henry Y\l\, forty-five years after the death 
of Edward IV— she was not married. The rental book of the 
ninth Earl of Kildare, " proves that, at that date, 1 528, Shela was 
still the wife of Sir Thomas of Desmond." At her death, which is 
recorded in one of the Pedigrees compiled by Sir George Carew, Earl 
of Totness, where we find " she died in A. D. 1604," she had there- 
fore been a widow for seventy years •; and as she had been a mother 
within four or five years of the commencement of her widowhood, 
physiology and common sense point out that the old Countess was 
probably about 100, and not 140, at the time of her death. 

MARY BILLINGE 

is noticed in the London Times of January 26th, 1864, as having died 
December 20th, 1863, at the age of 112 years. 

An investigation of the register of births and baptisms showed that 
she was born November 6th, 1772, christened December 23d. Her 
tombstone records her age at 112, notwithstanding the proofs of her 
true age were published less than six months after her decease. 

FREDERICK LAHRBUSH 

came to New York City in 1848. He claimed at that time the age of 
82, and to have been bom March 9th, 1766, in London. This history 
which he gave of himself and to the verity of which he adhered, and 
which was accepted by the public, Avas quite distinguished. He 
entered the British army on October 17th, 1789 ; sen-ed with the 60th 
Rifles under the Duke of York in the low countries, in 1793; ^^ 
present on the 8th of September, 1798, when the French General 
Humbert surrendered to Lord Comwallis at Ballimanuck, in Ireland ; 
was with Nelson in 1801 at the capture of Copenhagen ; witnessed 
the famous interview between Napoleon and Alexander, which led to 
the peace of Tilset in 1 807 ; fought under the Duke of Wellington in 
the Spanish Peninsula, in i8o8-'io, displaying such gallantry against 
Massena at Busaco as to secure a promotion ; was stationed at the 
Cape of Good Hope in the first Caffre war, and in 181 6-* 17 was an 
ofticer of the guard that had the custody of the Emperor Napoleon 
at St. Helena. After a service of twenty-nine years he sold out his 
captain's commission in the 60th Rifles in 181 8, and after residing in 
Australia, Tahiti and the West Indies, migrated to New York. The 



MVING AND DYING. 89 

people of New York believed his story. He was exemplary as a 
citizen ; a regular attendant at the Church of the Ascension, where 
for many years an arm chair was placed for the " old captain " in the 
middle aisle, just in front of the chancel rail. He went through the 
forms of kneeling and standing with military precision, his voice in 
the responses being heard above the rest of the congregation, piped 
as it was in a high treble. His habits of life and his reputed extreme 
age made Capt. Lahrbush a man of mark. Englishmen of high 
social position visiting New York, called upon him. His Royal High- 
ness the Prince of Wales when in the city, entertained him at lunch, 
or met him at lunch at the house of some citizen, and became 
acquainted with his reputed history. Admiral Farragut and General 
McClellan, we have seen it stated, were frequent visitors at his house. 
In the spring of 1870, a breakfast was given to him in memory of his 
104th birthday. This was repeated in 1872, on his io6th birthday. 
The dozen guests of General J. Watts DePeyster, who gave the annual 
breakfast, were, with few exceptions, generals of the highest dis- 
tinction. 

This case, which had been so widely noticed and so well known in 
this country, and in England as well, became an inviting subject for 
Mr. Thorn's dissecting knife. We give the result of his searching 
investigations. 

There -is scarcely a word of truth in Lahrbush's marvellous account 
of his age and adventures. We notice his statements in detail : 

He says he was born on the 9th of March, 1766, in London. No 
parish is specified. 

He entered the British army on the 17th of October, 1789. The 
War Office Gazette of that date contains no reference to him or such 
a name. 

He served with the 60th Rifles under the Duke of York in the low 
countries, in 1793. The 60th Regiment was then called the American 
Regiment, and not the Rifles, and the name of Larhbush does not 
appear in the " army list " of that period. 

He was present on the 8th of September. 1798, when the French 
surrendered to Lord Cornwallis, and with Nelson in 1801 at the cap- 
ture of Copenhagen. Still his name does not appear in the " army 
list." 

He fought under Wellington in i8o8-*io in the Spanish Peninsula, 
displaying such gallantry against Massena at Busaco as to secure 



90 MEDICAL SOCIETY OF NEW JERSEY. 

promotion. The Gazette which records the promotions after Busaco, 
makes no mention of Larhbush's good fortune, and the " army list " 
does not give his name. 

After a service of twenty-nine years he sold out his captain's com- 
mission in the 6oth Rifles in 1818. The *' army list " passes over his 
retirement with the same mysterious silence which it has observed 
with respect to his entrance upon it. 

In the army list of i8ig is an entry : 

Under the head of " cashiered," the reader will find the name of 
" Lieut. DeLarhbusch, 60 F." In writing to the War Office in 1846 
on the subject of his removal from the service, Lieut. L. spoke of 
the cause as his "youthful errors." If born 1766, he was 52 in 181 8 
— a time of life which does not justify the plea of youthful errors. 

The facts are, that he joined the army not in 1789, but in 1809, 
when his commission as Ensign in the 60th was dated. Again, Lahr- 
bush served only nine, not twenty-nine years. He never was a cap- 
tain, and had no commission to sell. He did not sell out, but was 
cashiered in 1819. 

NOTE B.— APPARENT DEATH. 

About 1854, Mrs. was confined with a fully-developed and 

healthy boy. It was born at full time and in natural labor. It did 
well for two days. On the third day, upon calling to see the mother, 
I found the baby apparently in periculo mortis. It had been taken 
suddenly ill a short time before " in a kind of fit." I sat down by the 
child and awaited its dissolution. It seemed so near to death that I 
was not prompted to do more. I watched it to its apparently last 
gasp. Everything indicated that life was extinct. The body was 
prepared for the grave, laid out and placed upon a table in the usual 
manner. I called the next day and found the child as well and as 
natural as ever. I learned from the family that some hours after it 
was laid out as for burial, a young woman, a neighbor, came in, and 
taking the covering from off the body, looked upon its deathly face. 
While thus standing over it, she passed her hand over its head, press- 
ing, as she did so, with her finger upon the anterior fontanelle. The 
child gave a convulsive start, opened its eyes, was immediately revived 
and apparently in health. It continued so, and has now g^own to be 
a healthy man.Jmarried, and with a family of his own. 



LIVING AND DYING. 9 1 

NOTE C— CARE OF THE BODY. 

It is reasonable to believe that, however cogent upon sanitary 
grounds may be the arguments for cremation, and however unobject- 
ionable may be the arrangements and external surroundings for the 
process, the sentiments of the living in regard to the body will ever be a 
hindrance to its general adoption. The place of the buried dead is 
dear to the hearts of those who survive, and the desire to be buried 
with the mortal remains of loved and venerated ones who have gone 
before, has not been lessened from the earliest history of buijal to 
the present time. It is more imperishable than the rock crypts of the 
early ages and the enduring monuments of the present. Among 
Christian nations, the belief in the resurrection of the body is in- 
wrought with the Christian faith, and the process of burning the 
body to ashes is obnoxious, however unscientific may be the popular 
view as to the ultimate elements of animal structure. The advocates 
of cremation in our day, with a few notable exceptions, are among 
those who do not accept the sublime verities of the future as they are 
disclosed by divine revelation. 

NOTE D. 

Senator Foot died about the time when *' Gates Ajar " was a very 
popular and widely-read book. Its title, new till its publication, be- 
came a common term in the conversation and thought of the people ; 
and its attractive suggestions as to the scenes of the future life, 
engaged the thoughts of devout minds, and doubtless those of the 
dying Senator. 

A distinguished clergyman died in 1862. In his earlier years he 
was a student at West Point, but resigned and prepared himself for 
the ministry ; but through all his future life his demeanor was per- 
meated with an element of military spirit and bearing. In one of the 
later years of his life he wrote a memorial notice of a clergyman with 
whom he was intimately associated, and whom he greatly admired. 
At the close of his notice he says of his death that his awakening was 
in that city of light that needed not the light of the sun, but of which 
" the Lamb was the light thereof." When he himself came to die 
his last words were, " I move into the light." 

At death the brain is anaemic. The mind is in a dreamy state. 
Old life scenes and trains of thought, modified by former habits, men- 



92 MEDICAL SOCIETY OF NEW JERSEY. 

tal constitution or study, formulate themselves into visions just as in 
the dreams of the healthy sleeper, and when uttered, as they often 
are by the dying, seem to be real and consistent. They are mental 
only— the immortal part, indeed, in exercise, but still held in bonds by 
the mortal. 

NOTE E.— FEAR IN DYING. 

A graduate of a German University, and educated for the priest- 
hood.in the Roman Catholic Church, came to this country to seek his 
fortune. His expectations were not realized, and to gain a living he 
learned a trade. His habits became bad, and after a few years of 
intemperance, he came to his deathbed. His disease did not affect his 
mind. His family well understood that he could not live, and I sup- 
posed that he had been by them informed of the fact. He was a 
man in middle life. His head was symmetrically developed, and 
thinly covered with hair about an inch long over all the scalp. On 
the morning of his death, upon entering his room and looking upon 
him, it was evident that he was moribund, and I so informed his wife. 
She went to his bedside and said, " The Doctor says you are djdng." 
He sat up in bed, looked at her and his children and others around, 
with a look of indescribable horror and extending his hand to each, in 
a hoarse sepulchral voice he bade them " good bye," the hairs on his 
head standing stiff and erect, like so many needles. He soon after lay 
down and died. His intelligent acceptance of the teachings of his 
church — thaji which no Christian church is more pronounced upon the 
doctrine of a future retribution — came to him now in these last 
moments of a wasted life. The call so sudden to face what he believed 
to be the realities of the future, was the occasion of this horrible death 
scene of twenty-nine years ago (July, 1855) which is photographed 
upon my memory. The characteristic phenomenon from the effect of 
fear I have never witnessed but on this occasion. 

Such an exhibition of fear in the dying hour is very rare. Our 
physical and psychical natures hinder it. When in the midst of the 
buoyant vigor of a healthy life and expectations of lofty purpose, 
severe sickness arrests the prosecution of cherished worldly schemes, 
the subject of it soon finds that the pains and discomforts of his new 
condition withdraw his mind from its former channels of thought. 
The fact neither disturbs nor annoys him. His thought centres in 
the urgent needs of his diseased condition. The busy world without 



LIVING AND DYING. 93 

ceases to excite interest or foster desire. The forces of life, hereto- 
fore so strong in driving to action, are broken. The high impulses 
and long-cherished, lofty purposes have lost their hold. The body 
weakened, the scope of mind is straitened ; and now, as comes the 
conviction— slowly, it may be — that all this betokens the approach of 
the end of all that is mortal, the mind peacefully accepts it — in 
appearance equally peaceful to the saint and the sinner : the one in 
Christian trust, the other in mute waiting in the presence of the 
inevitable. 

NOTE F.— THE ART OF DYING. 

A clergyman of long experience and with an acute knowledge of 
men, was once asked by an old physician, " Has it ever occurred to 
you that the aphorism, the * ruling passion strong in death,' is some- 
times illustrated in the religious ecstasies of the dying hour ? " The 
significant expression of face and his emphatic affirmative nod gave 
his reply, and confirmed the convictions which occasional observations 
have forced upon the mind of this writer. It is not to be looked for so 
much in those who have led an irreligious life, as in those of religious 
impulses. Self esteem and vainglory are elements of character which 
sometimes appear even in the manifestations of the death hour, 
They are, indeed, not consistent with the emotions of a truly humble, 
and pious spirit, but they show that even down to the last of earth 
the earthly abides. 

Perhaps Dr. Johnson had something of this sort in his mind when 
he said to his friend Boswell, ** The art of dying is of no importance, 
it lasts so short a time." 



ESSAY. 



BY CHARLES J. KIPP, M. D., OF NEWARK. 



On the Prevention and Treatment of Purulent 

Conjunctivitis. 

I am not sure but that I ought to apologize for having 
chosen for this paper a subject with which you are as 
familiar as I am, and concerning which I have nothing 
new to offer. Having had, however, the opportunity of 
treating many hundred cases of purulent conjunctivitis 
during the last fifteen years, I have thought a concise 
statement of the experience thus gained might not be 
entirely without interest to you. 

Beginning with the most frequently-observed and most 
important variety of this disease — the purulent ophthal- 
mia of the new born — I may state that I have no doubt of 
the correctness of the prevailing opinion that this disease 
is always the result of inoculation, and that in many 
cases at least, the disease can be prevented by the em- 
ployment of prophylactic measures. As long ago as 
1854, William Mackenzie* wrote as follows on this sub- 
ject : ** There is reason to believe that this disease is not 
unfrequently an inoculation of the conjunctiva by leu- 
corrhoeal fluid, during parturition ; and that, therefore, 
it might often be prevented by repeated injections of 
tepid water or a weak alkaline solution into the vagina, in 



A Practical Treatise on the Diseases of the Eye, Am. Ed., 1855, p. 460. 



96 MEDICAL SOCIETY OF NEW JERSEY. 

the first and second stages of parturition, and by carefully 
washing the eyes of the infant as soon as it is removed 
from the mother. The former precaution is scarcely ever 
and the latter too seldom attended to. The practitioner 
ought to acquaint himself beforehand with the fact 
whether the mother is affected with any vaginal discharge, 
and be prepared to use the means proper for averting the 
danger thereby arising to the chil^. If the vaginal dis- 
charge is not removed, or if, on the child being born, 
nothing is done to it for perhaps half an hour or longer, 
every chance is given for inoculation of the eyes. It 
will, in general, be found that, when the child becomes 
affected with this ophthalmia, the mother had leucorrhoea 
or gonorrhoea, and that the eyes were not cleaned for 
some time after birth." 

At present, vaginal injections are, I believe, but little 
employed for this purpose ; and instead of simple water, 
solutions of carbolic acid, of boric acid, of salicylic acid, 
of corrosive sublimate, of nitrate of silver, and of other 
antiseptics, are now used in many lying-in hospitals for 
washing out the child's eyes. Alfred Graefe* recom- 
mends irrigation of the everted lids with a two per-cent. 
solution of carbolic acid immediately after birth, and 
twice daily during the following two days. He advises, 
also, that in all cases in which the mother is known to 
have a vaginal blennorrhoea, the lids and the surrounding 
parts be thoroughly cleansed with the same solution, 
and that, if practicable, a compress, wet with this solu- 
tion, be kept constantly on the lids betw.een the irriga- 
tions. Credef has for some years instilled a drop of a 
two per-cent. solution of the nitrate of silver into the 



* Volkmann's Sammlung Klinischer Vortrage, No. 192, p. 1,594. 
t Archiv f. Gynakol. Bd. XXI. 



ESSAY. 97 

eyes of all children born in the hospital under his charge ; 
and It is claimed that since this measure was adopted, 
only four cases of purulent conjunctivitis have occurred 
among 1,029 children, while formerly this disease attacked 
more than nine per cent. In a lying-in hospital in 
Stuttgart,* where Credo's method was used, not a single 
case of ophthalmia neonatorum occurred among 361 
children born there in 1881, while in the three preceding 
years, from 9.6 per cent, to 14.3 per cent, were afflicted 
with this disease; and in the wards in charge of Drs. 
Carl and Gustav Braun, in Vienna.f as well as in other 
lying-in institutions in Viqnna, a considerable reduction 
in the number of cases has been brought about by the 
employment of this method.:]: 

Kehrer,! on the other hand, has, after a fair trial, 
abandoned the use of nitrate of silver, which in his hands 
produced marked irritation and watery secretion, not- 
withstanding great care was taken to prevent the solution 
from coming in contact with the cornea. At present he 
uses a one per-cent. solution of carbolic acid for irrigating 
the eyes of the child, but seems to rely chiefly on disin- 
fection of the vagina by means of a two pro mille solu- 
tion of corrosive sublimate in glycerine, as a preventive 
of the eye disease. By these means the frequency of 
purulent conjunctivitis, in his hospital in Heidelberg, has 
been reduced to between three and four per cent. 

The instillations of carbolic acid and nitate of silver solu- 
tions here mentioned have, moreover, found but little 
favor with ophthalmic surgeons, many of whom, including 
myself, think such solutions entirely too irritating to a 



* Bayer, Archiv f. Gynakol. Bd. XVIII. 

tFelsenreich, Archiv f. Gynakol. Bd. XIX, p. 495. 

tKonigstein, L. Archiv f. Kinderheilk. Bd. III. 

II Henry Schwarz, " American Journal of Ophthalmology," Vol. I, No. 1. 

7 



98 MEDICAL SOCIETY OF NEW JERSEY. 

healthy eye, and fear that they do more harm than good. 
In private practice it will be sufficient, I think, to care- 
fully wipe from the eyelids any vaginal secretion which 
may adhere to them, and to wash out the conjunctival 
sac with plenty of clean, tepid water, or, if you wish, 
with a saturated solution of boric acid, immediately after 
birth, before the child is put into the bath. 

In England, and other parts of Europe, measures look- 
ing to the dissemination among the people of knowledge 
regarding the cau^e of the ophthalmia of the new born, 
and the means to be resorted to for its prevention, have 
lately been under discussion irj medical societies, and steps 
have been taken to distribute among all classes of society 
cards of instruction, drawn up in the simplest possible 
language. The same might be done here by our State 
Board of Health, which has already done so much to 
enlighten the people with regard to the causes and the 
prevention of disease ; and I have no doubt that if this 
Society should see fit to recommend the publication of 
a circular embodying such information, the State Board 
would gladly do this. Most of the cases of blindness 
from ophthalmia neonatorum which have come under my 
notice were, as I have before remarked, the result of 
neglect on the part of the parents to put the case in the 
hands of a competent physician at the beginning of the 
disease ; and it is therefore reasonable to expect at least 
a reduction in the number of the hopelessly blind in the 
future, if the people are made aware that by early treat- 
ment of the disease the eye can be saved, and that 
neglect will probably result in blindness^ 

I believe it to be the duty of every physician attend- 
ing a case of purulent conjunctivitis to point out to the 
persons living with the patient the very contagious nature 
of the discharge from the eye, and to warn them not to 



ESSAY. 99 

» 

use any of the towels, washbowls and other articles used 
by the patient. Whenever it can be done, the patient 
should be isolated, and the nurses attending him should 
not only be compelled to wash their hands thoroughly 
with some disinfectant every time they have dressed the 
eye, but should be prohibited from going into other 
wards. 

Passing on now to the treatment of the purulent con- 
junctivitis of the new born, I may state that this disease 
varies considerably in severity in different cases, and that 
this difference, in all probability, depends on the quality 
and quantity of the virus jvhich extend the eye, and per- 
haps somewhat also on the general condition of the 
patient. Thus, for instance, I have seen, in a well- 
developed and otherwise healthy infant of a mother with 
gonorrhoea, the corneae of both eyes perforated on the 
fifth day of the conjunctivitis, when the case came under 
my care ; and, on the other hand, I have seen the puny 
seventh-month's child of a prostitute pass through a 
severe form of this disease without the. slightest corneal 
trouble, under no other treatment than ordinary cleanli- 
ness. In the great majority of the cases which are seen 
in private practice, the disease is of a comparatively mild 
character, and requires but little more than the frequent 
and thorough removal of the discharge by means of clean 
water to bring it to a favorable termination. But every 
now and then cases are met with, even in the best 
families, in which the disease, if not properly treated, 
leads to serious disease of the cornea and, consequently, 
more or less impairment and even total loss of vision ; 
and it is to the treatment which I have found most effica- 
cious in this class of cases that I desire more especially 
to call your attention. 

On looking over my case books I find that in 156 cases 



100 MEDICAL SOCIETY OF NEW JERSEY. 

« 

of ophthalmia neonatorum which came in the different 
stages of this disease under my care in the last six years, 
the corneae were damaged at the time the case came into 
my hands in 38, or 24.3 per cent. 90 per cent, of these 
156 cases did not come to me till the twelfth day of the 
disease, or later ; and as in all of these the discharge was 
still very profuse, it is apparent that they were all of a 
severe character. All of these cases were treated in the 
manner I shall describe further on, and with the following 
results. In less than two per cent, of the cases in which 
the cornea was clear at the time the patient came under 
treatment, slight superficial ulceration of the cornea 
developed subsequently. Although in each of the cases 
so affected the conjunctival disease had existed for more 
than two weeks when I first saw it, and the discharge was 
very profuse, the ulcers healed without leaving a scar 
sufficiently dense to impair vision. In the cases which I 
treated from the beginning of the disease, no disease of 
the cornea supervened. Of the cases in which the cornea 
was implicated at the commencement of treatment, 34 
per cent., or 7.1 per cent, of the whole number (156) of 
cases, lost useful vision in one or both eyes ; and in sev- 
eral of these, staphyloma developed, which lead to 
secondary glaucoma, and thus necessitated the enuclea- 
tion of the eye. Many of these Ccises of ophthalmia 
neonatorum occurred in well-to-do families, but the great 
majority among poor people who brought the children to 
the Infirmary for treatment. In about two-thirds of the 
cases, neither mother nor child had been under the care 
of a physician, but had been either attended by ignorant 
midwives, or had been entirely neglected. We thus see 
that the method of treatment employed in these cases 
not only prevents the development of affections of the 
cornea in all, or nearly all, recent cases, but that it is 



ESSAY. lOI 

capable also of arresting the progress of destruction in 
most of the neglected cases. 

Briefly stated, this method consists in scrupulous clean- 
liness, the application of cold to the lids in the early- 
stage, and the application of the nitrate of silver to the 
conjunctiva during the pyorrhoic stage. 

During the first few days of the disease — while the lids 
are hot and shining, the conjunctiva is tense and smooth, 
and the secretion consists of straw-colored water — I have 
found it best to do little more than to apply cold com- 
presses to the lids, and to clean the eyes at short intervals. 
I prefer absorbent cotton to sponges for wiping away the 
discharge, and for the purpose of removing the secretion 
from the conjunctival sac I drop water from an eye- 
dropper between the slightly opened lids. Formerly I 
used a syringe for cleansing the eye, but abandoned 
it on account of the danger of spirting some of the 
secretion in one*s own and the attendant's eyes. As a 
rulie, I have the eyes opened and cleaned at least every 
hour in the beginning of the disease, and later, when the 
discharge becomes more profuse, still oftener. The com- 
presses should be applied continuously in cases in which 
the lids are very swollen and hot, but in less severe cases 
I frequently apply these only for an hour three or four 
times daily. In severe cases it is best to cool the com- 
presses on a block of ice, but in all others they may be 
dipped in cold water ; care should, however, be taken to 
change them sufficiently often, as otherwise they will, by 
acting as poultices, do more harm than good. In order 
to thoroughly carry out this plan of treatment, it is of 
course necessary to have at least two nurses, as no nurse 
can be expected to do this work faithfully for more than 
twelve hours out of the twenty-four. In private practice 
I decline to undertake the treatment of any case at all 



I02 MEDICAL SOCIETY OF NEW JERSEY. 

serious, unless I can have some reliable and competent 
attendants with the . patient night and day during the 
whole course of the disease ; and my advice to you is to 
do likewise, if you want to make sure of obtaining good 
results. Of the various antiseptic solutions which have 
been recommended by different physicians for cleansing 
the eye, I have tried several, but cannot say that the 
cases in which I used ^em did better or were cured 
quicker than those in which simple water was used. 
More than thirty years ago, Mackenzie* recommended 
for this purpose a tepid solution of the bichloride of 

mercury — the most fashionable antiseptic of to-day — in 

ft 

the proportion of one part to 4,000 of water, with which 
the eye is to be washed out four times daily. " This 
collyrium,** he says, ** used in cleansing the eyes, tends 
gently to repress the discharges. Alone, however, it is 
not sufficient for that purpose, and we have recourse, 
therefore, to astringent solutions of more power. The 
solution of nitras argenti is what I have found most use 
ful." Boric acid, carbolic acid, the benzoate of sodium, 
and, indeed, all the antiseptics, are strongly recommended 
for this purpose by others, and some, like Becker,f use 
no other remedy during the entire course of the disease. 
He merely keeps a bit of linen wet with a one per-cent. 
solution of salicylic acid constantly on the lids, and 
occasionally has the eye washed out with the same solu- 
tion. Caustics are used by him only in cases which 
threaten to become chronic. Under this treatment he 
says he has not lost an eye. Dorij: washes out the eyes 
with a one per-cent. solution of tannin, and, in addition, 



*Op. Cit., p. 464. 

t Bericht iiber die i2te Versammluiig der Ophthalm. Gesellschaft, Heidelberg, 
1879, p. 119. 
JLoc. cit., p. 115. 



ESSAY. 103 

drops into the eyes a solution of the benzoate of sodium 
(one part to twenty of water) and a ten-per-cent. solution 
of tannin, alternately every fifteen minutes. He states 
that while this treatment did not shorten the stage of 
suppuration, it enabled the child to open its eyes on the 
second day of treatment. Graefe* used for a while 
nothing but a one-and-&-half-per-cent. solution of carbolic 
acid ; but further experience has taught him to mistrust this 
method, and to resume the caustic treatment. He is 
convinced that antiseptics alone cannot reduce the higher 
degrees of swelling of the conjunctiva, and thus prevent 
disease of the cornea. 

The frequent cleaning of the eyes, which I consider of 
the greatest importance in all stages of this disease, is, in 
Becker's opinion, not only unnecessary, but often pro- 
ductive of injury to the cornea, especially in the first 
stage, and he therefore omits it entirely, and merely pre- 
vents the gluing together of the edges of the lids and the 
accumulation of secretion in the conjunctival sac, by 
keeping constantly a wet cloth on the lids. 

In addition to the application of cold and the frequent 
removal of the secretion, I have found it necessary, as I 
have before said, to make applications of a solution of 
the nitrate of silver to the conjunctiva; and these I 
begin when the disease has fairly passed into the second 
stage — that is, when the lids have lost their shining 
aspect, and can be easily everted, the discharge has 
become thick, creamy and abundant, and the conjunctiva 
is soft, succulent and velvety. This usually occurs on 
the third or fourth day of the disease, but in some cases 
not till the fifth or sixth day. In former years, when my 
experience with this disease was more limited, I treated 



*Loc. cit., p. 150. 



I04 MEDICAL SOCIETY OF NEW JERSEY. 

several cases from the beginning with the caustic, and, in 
some of them, diphtheritic patches made their appearance 
in the conjunctiva and the corneae became implicated. 
Since then I have been in less haste, and in order to 
avoid all risk, have often allowed the purulent discharge 
to become profuse before making the application. As a 
rule, I begin with a one per-cent. solution, and if on my 
next visit on the following day I find that the discharge 
is still thick and no patches of coagulated fibrin adhere 
to the conjunctiva, I either use again the same solution 
or substitute a two per-cent. solution, if the discharge 
has rather increased than diminished in quantity. 
Immediately after the application of the caustic, I some- 
times apply cold compresses to the lids to mitigate the 
pain, but in most cases I entirely discontinue the cold 
compresses as soon as the second stage of the disease is 
thoroughly established. The cleansing of the eye must, 
of course be as assiduously attended to in this as in the 
first stage. In the great majority of my cases, I have not 
found it necessary to apply the two per-cent. solution of 
the caustic more than once in twenty-four hours ; but 
occasionally I have encountered cases in which the secre- 
tion was not speedily reduced by one application daily, 
and in these an application every twelve hours soon 
brought about a decided improvement. In cases which 
did not come to me till the second or third week of the 
disease — and in which the discharge was very profuse, the 
conjunctiva enormously swollen and covered with enlarged 
papillae, and the cornea was infiltrated of ulcerated, I have 
never hesitated to use a two or even three per-cent. solu- 
tion from the first, and to repeat the application twice 
daily till the discharge was much lessened. After that, I 
used the caustic but once daily ; and when the discharge 
assumed a muco-purulent character, substituted a one per- 



ESSAY. 105 

cent, solution for the stronger one, and subsequently in- 
creased the interval between the cauterisations to from 
two to three days. Knowing from the experience of 
others that the abrupt discontinuation of the daily appli- 
cation of the nitrate of silver is apt to be followed by a 
relapse of the disease, I have always endeavored to follow 
the above plan, but, as it is impossible to entirely control 
dispensary patients in such matters, have seen a number 
of instances in which, after an absence of from four to five 
days, while the eye disease was improving, the child was 
brought back in a worse condition than ever before. 

A few words as to the manner in which I make the 
application of the caustic solution may not be out of 
place here, for the results depend largely on this proceed- 
ure. In order to make the application in a satisfactory 
manner, it is necessary that the child's head should be 
thoroughly fixed ; and this I secure by placing the child 
in the lap of the nurse in such a way that its head, with 
its face upward, of course, rests between my knees. In 
mild cases I evert both lids at the same time, but in 
severe ones I evert each singly, and during the cauterisa- 
tion protect the cornea with the other. After I have 
thoroughly dried the conjunctiva, I apply to it the nitrate 
of silver solution with a large cameFs-hair brush ; and 
according to the effect I wish to produce, wait from one 
to several seconds Before I apply water to wash away the 
caustic. In simple cases I apply the water as soon as a 
thin film has formed on the conjunctiva, while in cases 
with excessive swelling of the retro-tarsal fold, I wait till 
the conjunctiva is tolerably white. I use a separate 
brush for each lid, and apply with it both the caustic and 
the water. After use, I have the brushes rinsed in warm 
water and dried. In this way, all danger of inoculating 
others with these brushes is avoided. 



I06 MEDICAL SOCIETY OF NEW JERSEY. 

With regard to the affections of the cornea which may 
be developed in this disease, I have found it advantageous 
not to interrupt the caustic treatment on account of such 
a complication, but rather to push it, so as to bring the 
suppuration to an end as speedily as possible. Diseases 
of the cornea call, in addition, for instillations of atropine 
or eserine. The last named remedy I formerly used a 
good deal more than I do now. At one time I thought 
that it not only exerted a favorable influence on ulcers of 
the cornea, but that it also assisted in diminishing the 
discharge. Further experience has, however, convinced 
me that it has no advantage over the sulphate of atropine 
in this respect ; and as it, moreover, not unfrequently 
causes hyperaemia, and even inflammation of the iris, and 
in many cases severe pain in eye and forehead, while the 
atropine is painless, I now use the latter remedy almost 
exclusively in these cases. Great care must, however, be 
taken in cases with ulceration of the cornea, to handle 
the lids very gently while applying the caustic, since 
pressure on the eyeball may cause a rupture of the floor 
of the ulcer, and the expulsion of the crystalline lens and 
the vitreous body. If perforation of an ulcer is threat- 
ened, it may be well to puncture the floor of the ulcer, 
though I prefer, in such cases, to apply a pressure band- 
age to both eyes for an hour at a time, several times 
daily. In cases of prolapse of iris in tfle corneal opening, 
I have rarely found it necessary to either puncture or to 
abscise the protruding iris. In most of these cases the 
prolapse disappeared when the conjunctivitis was cured ; 
and in the cases in which it did not disappear spontane- 
ously, I delayed operative interference for weeks after the 
conjunctivitis had subsided. 

With regard to the purulent conjunctivitis of older 
children and adults, I would at I have treated it in 



ESSAY. 107 

about the same way as the purulent ophthalmia of the 
new born ; and although the caustic treatment has, in 
this class of cases, and more especially in those resulting 
from the inoculation of gonorrhoeal virus, not unfre- 
quently failed to prevent serious disease of the cornea, it 
has, on the whole, given me better results than any other 
mode of treatment that I have tried. In robust persons 
I have often, in addition to the application of cold to the 
lids, resorted to local depletion by means of six to twelve 
leeches to the temple, for the purpose of reducing the 
inflammation and relieving the pain. For cleaning the 
eye I have used simple water, and solutions of boric acid, 
carbolic acid and the bi-chloride of mercury. Judging 
from the results, they all seem to be about equally effica- 
cious. In adults, too, I have always delayed the first 
application of the nitrate of silver till the swelling and 
hardness of the lids had considerably subsided, and the 
discharge was no longer ichorous but decidedly purulent. 
I have, moreover, always carefully watched the effect of 
the caustic, and have postponed the second application 
for forty-eight or more hours, if the eschar produced by 
the caustic was not thrown off twelve hours after the 
application. On the other hand, I have used the caustic 
in strong solutions and with freedom when the discharge 
was thick and very copious. The development of corneal 
disease in such cases has caused me to use it still more 
thoroughly. In cases of great swelling of the conjunc- 
tiva, I have also occasionally superficially scarified the 
conjunctiva of the lids immediately after the cauterisa- 
tion, and prolonged the bleeding from the incisions by 
the application of warm water to the conjunctiva. In 
cases in which the ocular conjunctiva was much raised by 
serous infiltration, I have sometimes made a number of 
incisions into it in a radial direction, by means of the 



I08 MEDICAL SOCIETY OF NEW JERSEY. 

scissors, but in only a few cases did I thereby prevent 
serious disease of the cornea. In a considerable number 
of cases with great swelling and stiffness of the lids, I 
have enlarged the palpebral fissure by dividing the outer 
commissure for half an inch with a stout pair of scissors, 
one blade of which I passed into the conjunctival sac 
behind the commissure and the other in front, and then 
closed them. The rather free bleeding attending this 
little operation has seemed to me to be of great service 
in these cases, and probably did as much good as the 
removal of the pressure from the cornea. Although this 
procedure is undoubtedly of considerable value, it should 
be resorted to only in severe cases, as, for forty-eight 
hours or longer after the operation, the cleaning of the 
eye causes great pain, and therefore interferes with it. 
The affections of the cornea occurring in the course of 
his disease in adults, I have treated in the same manner 
as in infants. 

Briefly summarized, the treatment I have found most 
useful in this disease in adults, has consisted in local 
depletion by means of leeches to the temple, the applica- 
tion of cold to the lids, very frequent cleaning of the 
eyes with simple water or solution of boric acid, the 
application of solutions of nitrate of silver to the con- 
junctiva in the second stage of the disease, superficial 
scarification of the conjunctiva after the cauterisation, 
and enlargement of the palpebral fissure by the division 
of the outer canthus. 

Under this treatment I have seen nearly all cases of 
purulent conjunctivitis in older children and adults, not 
due to gonorrhoeal virus, recover without serious damage 
to the cornea. Of the gonorrhoeal cases, unfortunately 
no such favorable report can be made. In a little more 
than one-half of these cases, useful vision was destroyed. 



ESSAY. 109 

in spite of the most assiduous attention on the part of 
the surgeon and the attendants. None of the antiseptic 
solutions previously named, even when used from the 
beginning of the disease, seemed to possess the least 
power to arrest the disease in many of the cases ; and in 
these the nitrate of silver also failed to prevent the 
effusion of much plastic material into the ocular con- 
junctiva and consequent disease of the cornea. In 
some other cases in which nothing but simple water was 
used besides the nitrate of silver, the cornea entirely 
escaped injury. Why this should be so I am unable to 
say, but it seems probable that in the cases on which 
treatment made no impression, the virus causing the 
eye affections contained either a larger number of the 
micrococci found by Neisser,* Haabf and others in the 
urethral secretion — as well as in the discharge from puru- 
lent conjunctivitis — than in the others, or that in the one 
set of cases the conjunctiva furnished more favorable 
conditions for the growth and multiplication of these 
organisms. 

It now remains for me to state what I have done to 
prevent the inoculation of the fellow eye, in cases in 
which but one was affected. Formerly I closed hermeti- 
cally the sound eye by means of picked lint and a piece 
of adhesive plaster, which was fixed by collodion to the 
nose, forehead and cheek. More recently I have used a 
contrivance suggested by Dr. Buller, of Montreal, which 
affords as much protection, and is much more endurable 
to the patient than the hermetical bandage. It consists 
of a shield of macintosh about four and a half inches 
square, with a watch glass fastened in a hole in the 



* Neisser, Med. Centralbl, 1879. Bd. 17, No. 28. 

t Beitrage z. Ophthalmalogie, Friedrich Horner gewidmet, p. 159. 



no MEDICAL SOCIETY OF NEW JERSEY. 

centre, through which the patient can see. This is care- 
fully fastened by broad pieces of strapping to the nose, 
forehead and cheek, the lower outer angle being left open 
for ventilation.* 

In well-to-do people who can employ the necessary 
nurses, and in-patients in hospitals, it is, however, not 
always necessary to do more than to warn the patients 
and the attendants not to touch the sound eye without 
having previously carefully washed their hands. In nine 
cases of gonorrhoeal ophthalmia of one eye only which I 
have treated in the last few years, the sound eye was not 
protected either by bandage or shield, and yet did not 
become affected. That these cases were of a severe 
character is evident from the fact that in only one, the 
cornea was not implicated ; in three, the corneae were 
seriously damaged, and in the remaining five, vision was 
totally destroyed. 



Nettleship, " Diseases of the Eye," American edition, p. 68. 



ESSAY. 



BY E. J. ILL, M. D., SURGEON TO WOMAN'S HOSPITAL, NEWARK, N. J. 



Seven Successful Cases of Ovariotomy Performed 
AT THE Woman's Hospital, Newark, N. J. 

In presenting these cases to the Society I am well 
aware that I am presenting nothing new. I am desirous, 
however, of putting them on record, and prefer to do so 
in the records of this Society. I will, therefore, offer no 
further excuse. 

Before going on to relate the separate cases, I will state 
what is common to all, so as not to put your patience to 
a test. 

I should here say that I never selected my cases, but 
operated upon all as they came into my hands. All 
operations were done under strictly antiseptic precau- 
tions. The first three ckses with, the last four without 
carbolized spray. 

All ligatures used were silk, previously boiled one 
hour in a six-per-cent. solution of carbolic acid. On the 
evening prior to the operation, all instruments were 
soaked in absolute alcohol. 

For six days before the operation, all patients under- 
went the following preparatory treatment : The patient 
received a hot bath every evening, after which she was 
well rubbed down with towels and put to bed. This was 
done for two reasons : first, to get the patient's skin in 
good order for free perspirations ; second, to thoroughly 



112 MEDICAL SOCIETY OF NEW JERSEY. 

disinfect her. She was clothed in good flannels during 
this time. From the first to third day she was prescribed 
0,6 of magnesia ponderosa three times daily. On the 
fourth day she was given 

Calomel 0,5 

Sodae bicarb. 0,3 

Sacch. alb. 2,0 

M. Div. in dos. No. V. 

Sig. — One powder every two hours until three evacua- 
tions had taken place. 

On the fifth day, unless contraindicated, a 15,0 dose of 
castor oil was given, and on the morning of the operation 
an enema, as also a large, hot vaginal douche. After this 
treatment I never had any trouble with intestines dis- 
tended by gas. 

During all this time the patient received five meals a 
day, consisting either of milk porridge, milk, beef soup, 
broiled lamb chops, lagerbeer, light wines or milk punch, 
as she desired. I considered all this very essential, and 
am positive of its beneficial result. 

Her surroundings were made comfortable and cheerful, 
and the patient assured of success after she had once 
consented to the operation ; previously to which she was 
candidly told of her chances. Her temperature was 
taken twice daily. The after-treatment consisted of one 
teaspoonful of hot water every fifteen minutes for twelve 
hours, to prevent vomiting from ether. This it certainly 
did, for none of my patients ever vomited from this 
cause. Occasionally a teaspoonful of brandy was given 
if circumstances required it ; still, this was only done 
with hesitation. For twelve hours following that, two 
teaspoonsful of barley water were given every twenty 
minutes, unless the patient was asleep. For the next 
two days, two tablespoonsful of barley water and two 



ESSAY. 113 

tablespoonsful of milk were given alternately every thirty 
minutes, or until gases are passed by the anus, when 
beef or chicken broth was ordered in 60,0 doses every 
two hours, alternately with a like quantity of milk. On 
the seventh day, milk and toast bread, as also rice and 
farina with milk, were allowed. Beef — raw and finely 
chopped, or tender lamb chops broiled were ordered 
as soon as the bowels had been moved, which was usually 
brought about by an enema of a pint of warm water on 
the ninth day. After the fourteenth day, ordinary diet 
was allowed. 

The stitches, which were always wire of pure silver, 
were removed on the ninth, tenth and eleventh days, 
never removing more than two or three at a time, and 
then alternate stitches only. Strips of adhesive plaster 
took their place. For the first eight days the urine was 
drawn every six hours, after which the patient was per- 
mitted to use the bed-pan. In my seven cases there had 
been two exceptions to this, both patients acquiring 
cystitis on the fourth and fifth day. The patient was 
allowed to rise on the sixteenth day, and was usually dis- 
charged on the twenty-sixth to thirtieth day. 

Case I. Mrs. J. B. (through. the kindness of Dr. J. Few- 
smith, Jr.,), aged 27 years, native of United States, family 
history good, was first menstruated at the age of 13 years. 
Has haci three children ; last child four and a half years 
ago, since which time she has been ailing, more or less. 
Contracted gonorrhoea three months previous to the birth 
of the last child. Patient has never been strong. Had 
It hemorrhage from the lungs one year ago, and cough 
previous to that and since. Six months ago she noticed 
an enlargement of the abdomen, which has rapidly 
increased in size since. 

On admission, September 7th, 1881, the patient 

8 



114 MEDICAL SOCIETY OF NEW JERSEY. 

appeared as a'very anaemic, slender-built woman of ner- 
vous temperament. On physical examination there is 
decreased respiratory murmur over the apices of both 
lungs ; heart and kidneys normal ; abdomen as large as a 
woman appears in the seventh month of pregnancy ; 
readily fluctuating ; dullness over the whole lower region 
of the abdomen. Upon deep pressure just below the 
umbilicus, a large, freely-movable body is found, very 
much resembling a foetus in a large sack of water. The 
fluid was drawn off and proved to be ascitic. An uneven, 
nodular, fluctuating, movable body was now felt, with a 
pedicle going to the right side, not connected with 
the uterus, and tapped. The fluid was of thick, gelatin- 
ous character ; presented the elements usually found in 
an ovarian cyst, namely, cylindrical epithelium, large 
fatty cells and, as proven by the reactions as given by 
Drysdale, the cells named after him. 

Diagnosis : Multilocular ovarian cyst of the right side, 
accompanied with ascites. 

Operation October ist, 1881, assisted by Dr. Balleray 
and the house staff", and Dr. J. C. Young administering 
ether. Antiseptic precaution and spray. 

An incision four inches long, commencing about one 
and one-half inch below the umbilicus, was made and 
struck the linea alba. 

The ascitic fluid was drawn off*, the tumor tapped and 
lifted out from the abdominal cavity, during which time 
the omentum, attached like a fan over the upper surface 
of the tumor, was doubly ligated in sections and cut. A 
moderately long pedicle from the right side was clamped 
with a French clamp. The abdominal cavity was thor- 
oughly cleansed from all fluids, a drainage tube placed 
into Douglas cul-de-sac, and the wound closed with seven 
silver sutures, taking in a liberal amount of peritoneum. 



ESSAY. 1 1 5 

The drainage tube was closed up, the whole covered with 
Lister's, antiseptic dressing, and a binder applied. The 
patient was put to a bed, previously warmed, and sur- 
rounded with hot bottles. The tumor weighed seventeen 
pounds and the ascitic fluid fourteen pounds — in all, 
thirty-one pounds. The operation lasted one hour and 
thirty-five minutes. 

The patient made a slow recovery. Twelve hours after 
the operation her temperature was 103^'*, but soon fell, to 
rise again on the fourth day to 105®, accompanied with 
great restlessness. Ice bags to the head and small hypo- 
' dermics of morphia were given. Temperature never was 
normal until the eleventh day. On the morning of the 
second day about 200,0 of bloody serum was removed 
from the drainage tube, and the cavity was washed out 
with the following solution : 

Acid, carbolic 1,0 

Sod. chlor. 4,0 

Aq. destill. 500,0 
until the fluid returned clear. (Thomas' Diseases of 
Women, p. 760.) After this I never found any more fluid 
in the cul-de-sac of Douglas. Removal of the glass drain- 
age tube on the sixth day and a smaller rubber tube sub- 
stituted, which was permanently removed on the eighth 
day. The stump was kept covered thickly with salicylic 
acid. There never was any tympanitis, never a chill, and 
I saw nothing that partook of a septic character ; nor was 
there any appearance of an inflammation to which I might 
ascribe this high fever. Her pulse never ran very high, 
the highest being 124 on the night after the operation. 
Respiration never was beyond twenty-eight per minute, 
and that was on the evening of the fourth day. Flatus 
passed for the first time on the fourth day ; bowels were 
moved on the tenth day, and the clamp came off on 



Il6 MEDICAL SOCIETY OF NEW JERSEY. 

eleventh day. It was not until the twenty-first day that 
the patient could be allowed to sit up. On the thirty- 
third day she was discharged with a well-fitting abdominal 
supporter. 

May 8th, 1884. Patient is now regular in her menses, 
lasting four days, and they are painless. Has not lived 
with her husband since the operation. 

Case 2. Mrs. E. T. (through kindness of Dr.Wm. Pierson) 
was admitted February 22d, 1882; aged 52 years; born 
in the United States ; widow ; ceased menstruating seven 
months ago ; had six children and one abortion ; last 
pregnancy eighteen years since, and normal. Eighteen 
months ago she noticed a swelling in the right inguinal 
region, which rapidly increased and was very movable. 
Patient was very emaciated ; unable to walk about from 
the encumbrance produced by the large size of the tumor. 

Physical examination : lungs, heart and kidneys nor- 
mal ; abdomen very large and uneven ; indistinct fluctua- 
tion ; tympanitis in both flanks and epigastrium ; tumor 
not movable ; uterus pushed to the right and two and a 
half inches deep. Contents of cysts : the same micro- 
scopic appearance as in last case. 

Diagnosis : multilocular ovarian tumor, probably orig- 
inating from the left side. 

Operation March 4th, 1882. Careful antiseptic precau- 
tions, including spray. Assistance, same as before. 

Incision of five inches, which is increased to seven 
inches, in the linea alba. Adhesions to omentum, and 
especially large adhesions to large and small intestines ; 
very little ascitic fluid. The peritoneal covering of the 
tumor is stripped off where the adhesions are situated, 
and left on the intestines, the vessels having been care- 
fully ligated. The omentum is ligated in sections and 
returned. Pedicle from the left side is secured by a 



ESSAY. 117 

French clamp, and cauterized with the sesquichloride of 
iron. Drainage tube is introduced and wound stitched 
.up with twelve silver wire sutures, taking up liberal 
amounts of peritoneum. The operation, lasting two and 
one-half hours, was very difficult. The tumor weighed 
forty pounds. 

The patient was carried to bed in an apparently dying 
condition. Frequent hypodermics of brandy and a num- 
ber (5) of pearls of amylnitrite were administered; auto- 
transfusion by raising foot of bed about twelve inches. 
For five hours the pulse was hardly perceptible, although 
the patient regained consciousness very soon. 

In the evening her temperature was loi^^ and pulse 
120, which was the highest pulse and temperature re- 
corded. After forty-eight hours, the patient passed first 
flatus. 

On the sixth day the drainage tube was removed to 
make place for a smaller rubber tube. Clamps came off 
on the fourteenth day. With exception of a slight cysti- 
tis on the eighth day, the patient made an excellent 
recovery, and was dismissed on the twenty-eighth day. 
About one week after that she acquired phlegmasia 
alba dolens, but recovered nicely in due time, and is a 
perfectly healthy woman to this day. Her menses never 
have returned. 

Case J, Mrs. M. F., of Somerville, N. J., admitted 
October 5th, 1882 ; aged 44 years ; native of Ireland ; 
married twenty-five years ; had five children and three 
abortions ; last pregnancy terminated one year ago in a 
miscarriage at three months ; first menses appeared at 
fourteen years, and were always regular; ceased menstru- 
ating one year ago. 

Her present illness dates back only ten months, when 
she noticed an enlargement of the abdomen, and soon 



Il8 MEDICAL SOCIETY OF NEW JERSEY. 

thought she felt quickening. She rapidly increased in 
size, and on the first day of May, 1882, had "labor 
pains," which continued for three days without producing 
the expected baby. Although dates did not exactly 
correspond she believed herself pregnant. In August 
she noticed a prolapsus of the uterus. The tumor had 
been tapped on two occasions. 

Present condition : Patient had to be supported to the 
clinic. Abdomen was greatly and symmetrically dis- 
tended ; resonance in both flanks and epigastrium ; fric- 
tion sound on palpating the tumor ; the whole uterus is 
prolapsed ; fluid removed from the tumor shows the 
characteristic Drysdale cells, blood corpuscles, large, 
round, fatty cells, and degenerated cylindrical epithelium ; 
also para — albumen. 

Diagnosis : multilocular ovarian tumor. 

Operation October 21st, 1882. All antiseptic precau- 
tions, including spray. Incision five inches long ; escape 
of three pounds of ascitic fluid. Small adhesions to 
omentum. 

The tumor proves to be one of the left ovary. The 
long pedicle is clamped and the stump seared with Pa- 
quelin*s cautery. I hoped to cure the prolapsed uterus in 
this way, otherwise I should have discarded the clamp 
in this case. The right ovary was much enlarged, con- 
tained several small cysts and was also removed, the 
ligated stump, seared with Paquelin*s cautery, having 
been returned into the cavity. There was some brisk 
hemorrhage from a tear in the broad ligment near the 
right ovary. Several ligatures controlled the hemorrhage. 
Toilet of the peritoneum, drainage tube and closure with 
seven silver wire sutures finished the operation in fifty- 
five minutes. Lister's dressing was applied and patient 
put to bed. Tumor .weighed forty pounds. 



ESSAY. 119 

One hour after the operation patient is cheerful ; has a 
temperature of gSi^ ; pulse, 88 ; respiration, 10 ; some- 
what irregular, sighing. Slight hemorrhage from the 
pedicle on the second day, which stopped spontaneously. 
First flatus passed in forty-eight hours after the operation. 

Highest temperature recorded was 100^, and highest 
pulse 100. This was on the seventh day, and was due to 
a small bed sore. 

Drainage tube was removed on the sixth day, and the 
clamp came away on the twelfth day. Solid food allowed 
on the tenth day, and dismissed on the twenty-ninth day 
after the operation. 

About one year later patient presents herself at the 
clinic. Complete prolapsus has returned. The pedicle 
had disconnected itself entirely from the abdominal wall. 

Case ^. Mrs. K. C. (history taken November 24th, 
1882,); native of United States; married four years; 
aged 23 years ; had one child at full term and one abor- 
tion at two months, one year ago ; menses appeared at 
age of 15 years; since her first child she was irregular, 
every two weeks, and lost much ; mother died of con- 
sumption ; always had some leucorrhoea. During the 
past three years she suffered greatly from pain in the left 
inguinal region ; severest at night. There was no desire 
for sexual intercourse, which was painful. 

Physical examination disclosed : heart, lungs and kid- 
neys normal ; cervix uteri large, severely lacerated on the 
right side. There was a bloody, stringy discharge from 
the uterus. Uterus measured two and three-quarter inches, 
and was tilted to the left. There was a large, very indis- 
tinctly fluctuating tumor, which she first noticed one year 
ago, reaching midway between the umbilicus and ensiform 
cartilage. It was movable, and the cervix uteri seemed 
to move with it. There was tympanites in both flanks 






I20 MEDICAL SOCIETY OF NEW JERSEY. 

and over the epigastrium. TJie following measurements 
were taken around the hip, over the umbilicus, thirty-two 
inches, and fifteen inches from the ensiform cartilage to 
OS pubis : 

On Dec. 4th, the following, 32!^ inches and 15 inches. 
December 26th, 35^ inches and 15 inches. 
January loth, 1883, 35 inches and 14 inches. 
January 23d, " 35^ ** " 16 
February 21st, " 36 " " 16 

Fluctuation now had become more distinct. A small 
quantity of light-colored and very thick fluid was 
removed. Dr. T. M. Prudden, of New York, had the 
kindness to examine it, and pronounced it ** a fluid which 
has the characters common to those of ovarian cysts." 
Besides the usual microscopic appearance, it contained 
para-albumen. 

Diagnosis now was : multilocular ovarian cyst, prob- 
ably of left side. 

She was admitted to the hospital on March loth, and 
operated upon on March 17th, 1883. All antiseptic pre- 
cautions, excepting spray. 

Incision of four and one-half inches, striking a little to 
the left of the linea alba. No ascitic fluid. A multilocu- 
lar cyst, weighing sixteen pounds, was tapped and 
removed in the usual way, after the pedicle had been 
doubly ligated, cut and the stump seared with Pa- 
quelin's cautery. It proved to be the right ovary that 
was degenerated. There was considerable hemorrhage 
from a tear in the broad ligament, which resulted from 
the tightening of the ligature. It took two transfixed 
ligatures, two ligatures to bleeding vessels directly, and 
the cautery, to control it. The other ovary was healthy. 
" Toilet *' of the peritoneal cavity, drainage tube, closure 
of wound with eight silver sutures, dressing with iodoform 



ESSAY. 121 

and Lister's gauze finished the operation. The operation 
lasted one hour and twenty minutes. " The greater part 
of this was spent in the arrest of hemorrhage. 

The patient's highest temperature was loif, on the 
evening of the operation. After eighteen hours, she 
passed first flatus. There was never any drainage, and 
the drainage tube was removed on the fifth day. Patient 
was dismissed cured on the twenty-third day. 

On August 1 8th, 1883, patient miscarried at three 
months. Another miscarriage took place on February 
23d, 1884. There seemed to be no reason for this. At 
this date the patient is well, though still complains of 
the same pain in the left side which she had previous to 
the operation. 

Case 5. Mrs. M. B., of Newark, N. J. ; married ; aged 
46 years ; German ; family history good ; first menstrua- 
tions at 18 years ; general health good ; had fourteen 
children and no miscarriages; last child two years ago, 
which presented with left shoulder and was turned to a 
head presentation by the writer. She menstruated regu- 
larly, of normal amount and painless. 

On August 20th, 1883, physical examination reveals a 
very large abdomen, measuring thirty-seven inches over 
the umbilicus and hips, and sixteen inches from xyphoid 
cartilage to os pupis. There is very distinct fluctuation 
over the whole tumor, and tympanites in both flanks and 
epigastrium. Uterus situated to the right and under the 
OS pubis measures three and one-quarter inches. Cervix 
uteri is deeply lacerated. Greater resistance in the right 
iliac fossa. 

Diagnosis : ovarian tumor, probably of the right ovary. 

On September i8th removed 600,0 of dark-brown, 
thin, opake fluid, glittering with crystals of cholesterine. 
Tapping decreased the size of the tumor evenly and 



122 ■ MEDICAL SOCIETY OF NEW JERSEY. 

made it flabby, so that the diagnosis of a monocyst was 
made. The microscope showed flat epithelium in all 
stages of fatty degeneration, crystals of cholesterine, 
Drysdale cells, pus corpuscles and blood corpuscles in 
various forms. 

Admitted to the hospital on October 14th ; she was 
operated upon on October 20th. All antiseptic precau- 
tion, excepting spray. 

An incision four inches in length struck the linea alba. 
The tumor was tapped and the sack gradually drawn out. 
It was found to be attached by a very short and broad 
(4 inches) pedicle, originating in the right ovary. This 
was transfixed, doubly ligated and the tumor removed. 
The other ovary was healthy. " Toilet," drainage tube 
and seven silver wire sutures finished the operation. The 
wound was covered with iodoform, about 2,0, and Lister's 
gauze. The operation lasted one hour. About five hours 
after the operation, patient vomits about 50,0 of watery 
fluid. 

At 8 P. M. her temperature is 102 and pulse 92 ; respi- 
ration 16. Skin is moist and patient is restless, for which 
an ice-bag to the head and one-eighth grain of morphia 
every two hours are ordered. 

On the next morning there is a decrease in her temper- 
ature, but the patient is of ugly disposition, which is 
contrary to her nature. Dressing was changed, more 
iodoform sprinkled over the wound, and 15,0 of pure 
bright blood removed from the drainage tube. The 
abdominal cavity was carefully washed out with the same 
solution as was described in Case i. 

About noon the patient feels very weak, and her ugly 
disposition increases. At 5 P. M. she passes flatus. 

On the third day her temperature, pulse and respiration 



ESSAY. 123 

are quite normal. There was 30,0 of sero-sanguinolant 
fluid in the cul-de-sac of Douglas. 

On the fourth day there was no change in the condition 
of the patient, except that her uneasy disposition still 
continued. In the evening, slight cystitis developed. 

On the fifth day, A. M., pulse was 100, temperature 
I02f, and respiration 23. There was a bloody, bad- 
smelling discharge from the vagina, and carbolized douche 
was ordered every six hours, and the vulva covered with 
borated cotton. 

At 6 P. M. pulse was 120, respiration 28, temperature 
104^. Complains of great thirst, coughs considerably, 
uses angry words, strikes about with her fists. I expected 
the worst for the night. After studying the case, it sud- 
denly occurred to me that the patient may be suffering 
from iodoform poisoning. The dressing was removed, all 
the iodoform washed off carefully and salicylic acid sub- 
stituted. During the night the patient jumped from her 
bed several times, fighting with the nurse, althou'gh large 
doses of morphia were given, as were also large doses of 
milk and brandy. 

On the sixth day, at 7 A. M., she was much quieter. 
Temperature, \o\^\ pulse, 112; respiration, 21. In the 
evening her condition was the same as in the morning. 
Patient is not aware of her conduct during the previous 
night. 

On the seventh day, A. M., pulse and temperature are 
normal. The salicylic acid produced considerable redness 
about the skin, and is washed off. As a test, iodoform is 
again sprinkled over the wound. At this time the patient 
had regained her former cheerful disposition. In the 
evening she has a slight rise in the temperature — loof. 
The drainage tube is removed. 

On the eighth day, at ii A. M., her temperature is 



124 MEDICAL SOCIETY OF NEW JERSEY. 

loij, pulse 84. Patient is getting restless, and in the 
evening her temperature is I02|^, respiration 20, pulse 
108. Cough is increasing, and there is an increase of 
blood from the vagina, the odor not being unpleasant. 

On the ninth day her uneasiness increases, and temper- 
ature is 102^ in the morning. The iodoform is now 
removed, and gauze covers the wound only. Bowels 
moved and stitches removed at the usual time. 

On the tenth day patient is again cheerful, and nothing 
further occurs. She was dismissed cured on the twenty- 
second day. 

Case 6. Mrs. L. J., admitted June 29th, 1883 J aged 40 
years ; married ; mother of three children ; was first 
menstruated at the age of 13 years, and usually regular ; 
her mother died from some abdominal tumor ; last preg- 
nancy seventeen years ago. During the past five years, 
patient menstruated only with the most excruciating 
pains. She is anaemic, excessively nervous, and unable 
to be about ; has stabbing pains in the abdomen, with 
tenderness on pressure ; cannot retain her water longer 
than an hour, and passes it with pain. All these symp- 
toms are greatly aggravated when she gets unwell. 

Physical examination reveals a fluctuating abdominal 
tumor, reaching about one inch above the umbilicus. 
Upon deep inspirations, it allows the intestines to float 
over it for about three inches. Uterus is elevated, pushed 
to the right, and measures three inches. The tumor is 
adherent all over the pelvis. About 100,0 of thick, 
chocolate-colored fluid is removed by aspiration, which 
contains various degenerated forms of white and red cor- 
puscles, and also well-defined Drysdale's cells. From the 
absence of other elements, the diagnosis of an ovarian 
tumor is made only hesitatingly. Patient is so much 



ESSAY. 125 

better after tapping that she prefers to wait before she 
underjgoes any further operation. 

By November 1 8th, 1883, when she was readmitted, 
the tumor had increased to its former size, and was 
operated upon on November 24th, 1883. The plan of 
operation was to open the abdominal cavity, stitch the • 
cyst wall to the abdominal walls, and allow the tumor to 
heal by drainage. 

An incision of three inches showed the adhesions to 
be as large as was anticipated, extending over the whole 
pelvis and left side of the abdominal walls, the anterior 
surface of the tumor alone being free. The cyst wall was 
nearly three-eighths of an inch thick, so that a Spencer 
Wells trocar could not enter. The sack was then cut with 
a knife and the thick, grumous, bloody mass removed, 
care being taken to prevent its getting into the peritoneal 
cavity. About ten square inches of the cyst were drawn 
out, at the suggestion of Dr. Wm. Pierson, who kindly 
assisted, and the walls stitched to the abdominal walls. 
The amount of sack pulled out was cut off and the edge 
stitched to the skin. After the cavity had been thor- 
oughly cleansed with a two-and-one-half per-cent. solu- 
tion of carbolic acid, a rubber drainage tube was inserted 
and the wound covered with iodoform and gauze. The 
operation lasted one and one-half hour. The discharge 
from the cyst was immense for the next three days ; her 
general condition, however, was good. Patient passed 
flatus after thirty-six hours ; no fever. 

On the fourth day patient feels very weak and desires 
solid food, but is nauseated. She is ordered 100,0 of 
expressed beef juice as an injection into the bowels, 
three times daily, which is continued for a week, and is 
born very well. Several of the stitches were cut on the 
sixth day. On the fourteenth day about 10,0 of tincture 



126 MEDICAL SOCIETY OF NEW JERSEY. 

iodine comp. is injected into the cyst, and soon thereafter 
thoroughly removed by carbolized water. The injections 
of iodine are repeated every twelfth day thereafter. 

On December 14th the patient menstruates without 
pain for the first time in five years. 

January 17th, 1884, the cyst having been apparently 
obliterated, the drainage tube is removed. An examina- 
tion now reveals that the uterus is quite movable, but 
displaced to the right. No trace of a tumor, excepting 
more than ordinary resistance at the inlet of the pelvis. 
The patient is dismissed on February loth, apparently 
cured. 

February 12th. Patient menstruates painlessly, and the 
menses do not produce any discharge from the small 
fistulous opening. Her appetite is good, eating five 
meals daily. Her form has become rounded, her color 
natural and her disposition joyful. 

March 14th. Patient menstruates and has severe pains 
in the abdomen — just such pains as she had before the 
operation. Abdomen is very tender, tympanitic ; tem- 
perature, 102^ ; pulse, 120. With cessation of flow, the 
pains ceased. The patient was comfortable, and again 
able to perform her household duties. 

On April loth I was sent for again, and find the patient 
in the same condition as at the time of her last menstru- 
ation. Again, with the cessation of the flow the pains 
stopped. About ten days later, an examination per 
vaginam reveals considerable resistance in the left para- 
metrium. By conjoined manipulation, indefinite outlines 
of a tumor can be made out. The small fistulous open- 
ing, which was still left, was now probed to the extent of 
about two and one-half inches. A larger probe followed 
the smaller one, and soon I was able to introduce a sea- 
tangle tent, which is left for six hours. A gush of thick, 



ESSAY. 127 

bloody-colored fluid follows its removal — probably not 
more than 200,0 grm. A drainage tube is again intro- 
duced and the cavity syringed with a solution of mercuric 
chloride in water (1-1,000). On May 7th the patient 
menstruates painlessly. There is no more discharge from 
the cyst than there was for the past two weeks. Patient 
is about and able to attend her household duties. 

Case 7. Mrs. Emma G., admitted December 7th, 1883 ; 
30 years of age ; native of the United States ; married 
seven years ; family history good ; was first menstruated 
at 16 years, and very regular, lasting four days, and 
suffered from pain for four days previous to the flow. 
Had a child at full term five years ago, and one miscar- 
riage three years ago at seven months. Duration of 
present illness, two years. 

Two years ago patient had severe pains in the back and 
constant vomiting, lasting several months. She then 
noticed a tumor in the right side, which rapidly grew. 
One year ago she ceased menstruating, and then she 
increased still more rapidly. There proved to be ascites, 
and was first tapped by her physician in December, 1882 ; 
. from thence she was tapped on six or seven occasions. 
Patient is certain, however, that twenty-two pails, or 
about 176 liter, of fluid were removed ; and all this in 
course of a year. 

On admittance, the abdomen was found equally dis- 
tended in all directions, very fluctuating, and an uneven 
tumor only found upon deep pressure, which seemed to 
be in very close connections with the left inguinaf region. 
The uterus was displaced upward and to the left. Some 
of the ascitic fluid was removed, and the outlines of the 
tumor made out distinctly. Some of the fluid from the 
tumor was also removed, and was found to be character- 
istic fluid of an ovarian cyst. 



128 MEDICAL SOCIETY OF NEW JERSEY. 

Diagnosis : multilocular ovarian tumor, probably of the 
Teft side, although the patient insisted that it originated 
in the right side. 

Operation December 13th, 1883. All antiseptic pre- 
cautions excepting spray. 

Incision seven inches long in medium line. Ascitic 
fluid, thirty-three pounds, was drained off. The cyst was 
then punctured with a troicar ; the fluid, however, was 
so thick that it would not flow through a three-quarter 
inch tube. The tumor was now grasped with vulsella and 
the septa between the cysts broken down, and the whole 
gradually extracted from the abdominal cavity. There 
were very extensive adhesions to the omentum, which 
were, treated as in the previous cases. A very large 
adhesion to the left parietes extended from three inches 
above to one inch below the crest of the ilium. For an 
equal distance it extended anterior to spine of the ilium, 
and posteriorly to the middle of the crest. This adhesion 
was separated from behind forward, leaving a large piece 
of the peritoneal covering of the tumor, which was after- 
wards stitched over this large wound, like a flap over an 
amputated limb. Many vessels were ligated at this 
place. It was now found that the tumor originated by a 
very long pedicle from right side, and that the left ovary 
was healthy. The right Falopian tube was adherent to 
the tumor, even at its junction with the uterus. The 
whole pedicle was transfixed and doubly ligated. The 
tumor was now separated, the stump seared with Pa- 
quelin's cautery, and the whole dropped. The abdominal 
cavity was filled with colloid matter, and was only cleansed 
after pouring in a large quantity of two-and-one-half-per- 
cent. solution of carbolic acid and thoroughly sponging it 
out. The wound was closed up with ten silver wire 
sutures, and a drainage tube introduced in the cul-de-sac. 



ESSAY. 1 29 

The wound was covered with iodoform. The tumor 
weighed twenty-two pounds, or fifty-five pounds in all. 
The operation lasted one and a half hours, and was very 
difficult. 

During the last fifteen minutes the patient lost all pulse 
at the wrist ; had cold hands and feet. Hot bottles were 
applied to the latter. 10,0 grm. of brandy, as were also 
ten drops of tincture of digitalis, injected hypodermically. 
Auto-transfusion, by raising the foot of the table about 
twelve inches. I had no doubt but that the patient was 
dying. She rallied, however, very soon, and at 6 P. M. 
her temperature was looj ; had a good pulse at 128, and 
twenty respirations per minute. 

On the next morning there was no fluid in the drainage 
tube, and patient had no fever. In twenty-four hours 
after the operation the patient passed flatus. The patient 
got well without a bad symptom. 

The drainage tube was removed on the sixth, and the 
stitches on the ninth to eleventh day. She never had the 
slightest tympanites ; and from this it occurred that the 
intestines did not come down to separate the anterior 
from the posterior abdominal wall, and the two were 
adherent for two months before the adhesion gave away. 
On January 8th, 1884, the patient was dismissed cured. 

May 28th, 1884. She now menstruates regularly and 
painlessly. 

As I close with the narration of the cases, a rapid sur- 
vey might be interesting. 

Out of these seven patients, two were between 20 and 
30 years, one between 30 and 40 years, three between 40 
and 50 years, and one over 50 years. All had been 
married women. Two had i child, two had 3 children, 
one had 5 children, one each had 6 and 14 children. 



9 



I30 MEDICAL SOCIETY OF NEW JERSEY. 

making altogether 35 children. The number of pregnan- 
cies were 39. 

Three patients had ascites to a greater or less extent. 
All patients had been tapped, either for the purpose of 
relieving her, or for diagnosis. From this I never saw a 
bad symptom, if done under careful antiseptic precau- 
tions. Adhesions with the abdominal walls were found 
twice, once with the whole cavity of the pelvis, once with 
the intestines, and five times with the omentum. In two 
cases there were no adhesions. In one case the incision 
was 3 inches long, in two cases 4 inches, in one case 4^ 
inches, in one case 5 inches, and two cases 7 inches. All 
were multilocular but two. 

In four cases the right ovary was affected, in one case 
the left, in one both, and one was uncertain. Six opera- 
tions were complete and one incomplete. Six were 
entirely cured and one is under fair way of cure. I may 
also say that I have found Drysdale cells in all cases. 
I always relied upon the chemical test, not upon the 
appearance of the cells only. I have used a drainage 
tube in every case, but never one with side opening, 
which I have cause to believe to be irritating, and never 
regretted in doing so. 

It was remarkable that a sudden and great amount of 
shock, as shown by a sudden decline in the heart's action, 
was produced at the moment the tumor was lifted out 
from the abdominal cavity, or when, from any reason, a 
great amount of traction was made upon the pedicle. 
This was carefully observed in all cases by Dr. J. C. 
Young, to whom I am much indebted for the expert 
manner in which he administered ether, as well as his 
well-directed efforts in sustaining the patients' strength 
during the operations. This observation seems to me to 
be of great moment, and was one reason why I discarded 



ESSAY. 131 

the clamp, fearing that any great continued tractions 
upon the sympathetic nerves — for such must be the 
explanation, as would be the case if the patient had 
much tympanites — might seriously interfere with her 
recovery. 

Thus I have reported to you a small number of cases, 
and all my cases in as short words as possible. The 
result is gratifying to me in the extreme, and well repays 
the hard labor and anxiety they have caused me. 



REPORT OF STANDING COMMITTEE. 



-•-♦►♦- 



The reports received by the Standing Committee upon 
the medical history of the State for the past year were 
furnished promptly and are unexpectedly complete, when 
the fact is considered that some members of the District 
Societies are so thoughtless in the duty of forwarding 
their observations to the reporters who, for themselves, 
deserve much commendation. Seventeen of the twenty- 
one are, in consequence of their promptitude, eligible to 
membership in the Society. The Committee would 
earnestly renew the suggestion that each Society should 
appoint one of their number in each city or township to 
the service of reporting his own locality to the district 
reporter. 

The year has been a notably healthy one. Endemic 
diseases and the special diseases of the seasons have been 
ordinarily of less severity than heretofore, while epidem- 
ics have been limited in number and restricted in in- 
tensity to a greater degree than in many former years. 
Little of moment has occurred that calls for the special 
attention of medical men. The Committee, therefore, 
have less of real interest to relate upon subjects which 
have been interesting themes of former annual reviews. 
Mumps and measles were the two most prevalent endem- 
ics, being mentioned as very general by every district 
reporter. 

The death-rate has been diminished, in comparison 
with that of former years. Phthisis pulmonalis, it would 



134 MEDICAL SOCIETY OF NEW JERSEY. 

appear, has not added its usual lai^e proportion to the 
number of deaths. This may be, in a measure, due to 
sanitary improvements through the State, and also a 
promising evidence of success to efforts scientifically 
directed towards the prevention of disease. 

The meteorological conditions of the year have been 
noteworthy. The summer was cool throughout, with a 
singularly dry, bracing atmosphere. After a prolonged 
autumnal season, in every way delightful, the low tem- 
perature of the winter months was maintained with 
remarkable uniformity, although the storms were frequent 
and much snow fell in the eastern part of the State. 
There has been an absence of the usual high winds of 
spring. With these propitious conditions was allied an 
improved general state of health. 

So far as the Committee have been apprised, seven of 
our professional associates have been removed by death. 

B. Rush Bateman died at Cedarville on the 23d of July, 
1883, in the 77th year of his age. Dr. Bateman was for 
seventeen years a Fellow of this Society. He was one of 
the most genial of men. By his kindness and gentleness 
of disposition he endeared himself to the community in 
which he resided and to his professional brethren. All of 
us who were present a few years ago when our Society 
met in this city, can well remember his speech of wel- 
come — the hearty, whole-souled greeting with which you 
were urged to accept the good cheer of South Jersey. 
Every word came from the heart. It was ever his 
especial delight to meet with his professional associates. 
His death leaves a void in this Society and in the Cum- 
berland Medical Society, in which, a short time before 
his death, he was elected an honorary member. 

Paul S. Heritage, of Gloucester County, died at Man- 
tua on the 2d of October, 1883, ^g^<^ 33 years, James 



REPORT OF STANDING COMMITTEE. 1 35 

Clark Fitch, of Warren County, died at Hope, March 22d, 
1884, in the 92d year of his age. Lewis Mackey Osmun, 
of Warren County, died at his home in Phillipsburg, 
March 20th, 1884. John Alexander Somerville died on 
Thursday morning, April 3d, 1884, in Union Hill, Hudson 
County, aged 24. Joseph C. Weatherby died in Clarks- 
boro, April 20th, 1884, aged 72 years. John M. Cuyler, 
U. S. A., died at Morristown. Dr. Cuyler was an honor- 
ary member of the Morris County Medical Society. 

The Committee are pleased to acknowledge the recep- 
tion of a report from every county in the State, and have 
additional pleasure in announcing that Cape May has 
completed the entire enrollment of counties by reorgani- 
zing their Society, and are present to-day, not only to 
give a right royal welcome to their beautiful city by the 
sea to the State Society, but also with a formal request 
for a renewal of fellowship with them. A report on the 
health of their county will be found in its appropriate 
place. 

Atlantic County reports more than the usual 
amount of sickness from its eastern portion. A severe 
epidemic of dysentery visited Hammonton, New Ger- 
many and Elwood last summer. The onset of the disease 
was marked by a profuse discharge of blood, unaccom- 
panied with pain, but followed by great prostration. 
When not promptly treated, stimulants and tonics 
seemed requisite to rally the patients. Dr. North saw an 
unusual number of cases of rheumatism and bronchitis 
during the winter, and at present is in the midst of a 
mild epidemic of measles. Atlantic City appears to have 
been especially healthful ; Dr. Boardman Reed says, 
** more so than in any previous year within his experi- 
ence.*' German measles were prevalent during the 



,^6 MEDICAL SOCIETY OF NEW JERSEY. 

autumn and early winter. It was due to this fact, 
together with the rare occurrence of a genuine case, that 
sensational reports were sent abroad of a scarlatinal 
epidemic in the city. Follicular tonsillitis of a mild type 
was frequently observed, while not a single case of diph- 
theria has occurred among residents. The effect of the 
bracing atmosphere at the seashore upon the large number 
of children suffering with cholera infantum or enterocolitis 
seems remarkable. Indeed, the reporter states that if the 
little patients have sufficient strength to hold out for a 
few hours after their arrival, they recover almost without 
exception. Seventeen deaths were recorded as resulting 
from these diseases — certainly a small number when so 
many are brought to the seaside as a last resort. Typhoid 
and remittent fevers were not known to occur in the 
practice of any physician. Visitors from malarial regions 
brought in a few cases of intermittent fever, which were 
uniformly easily subdued. Residents are notably free 
from lung affections. Only thirteen of the 191 deaths 
during the year are charged to acute affections of the 
air passages as the cause, and only twelve to phthisis. 
Temporary illness Avas frequently observed among adults 
during the summer months, due to imprudence in diet 
and mode of life. For the information of physicians 
who may wish to know of the climatology of Atlantic 
City, through the courtesy of Sergeant Blunden, of the 
U. S. Signal Corps, a table has been appended to this 
report, showing the range of the thermometer, barometer 
and mean humidity for the year. 

In Bergen County there has been less than the usual 
amount of sickness. Periodical fevers have always been 
prevalent during summer and autumn in this county. 
Within the last few years it has been observed that they 



REPORT OF STANDING COMMITTEE. 1 37 

have been gradually decreasing in amount and in obsti- 
nacy, while fevers of a typhoid or typho-malarial charac- 
ter are taking their place. Bowel troubles prevailed to a 
less extent than usual. They were of a very mild type* 
and were readily subdued. Scarlet fever was occasionally 
met with from January to August, also diphtheria ; but 
both were much milder than in the previous year. A 
singular characteristic of a mild epidemic of measles in 
the neighborhood of Tenafly was a persistent eczematous 
eruption behind the ears and about the roots of the hair 
over the temporal region, remaining for some months 
after recovery. Influenza and follicular sore throat were 
of frequent occurrence from July to the present time. 
The latter was conspicuous by its contagious character 
among families. Bronchitis was the most noticeable lung 
trouble during the winter. Pneumonia was occasionally 
met with, while inflammatory rheumatism was frequent 
in an obstinate form. Wrapping the inflamed joints in 
cotton and oiled silk was preferable to bathing them with 
the customary liniments. Typho-malarial fever continued 
to an alarming extent at Englewood from September to 
the first of the year. A large nuniber ran a course of 
over twenty-four days ; one, a straight course of forty-six 
days, with a moving temperature. Diarrhoea and hemor- 
rhage were absent in all of the cases. This epidemic is ♦ 
stated to have originated from the use of impure water 
with defective plumbing, during the season in which 
malaria is most predominant. Acute arteritis occurred 
in several of the more prolonged cases. It was more apt 
to seize upon those who undertook to walk too soon after 
convalescence — before the lower limbs were sufficiently 
strong to bear the weight of the body. The arteries 
most frequently affected were the femoral, the popliteal 
and the tibial. In one case the femoral artery appeared 



138 MEDICAL SOCIETY OF NEW JERSEY. 

* 

to be entirely obliterated. Pain was severe along the 
course of the vessel, together with a cord-like feeling 
under the finger. 

In Burlington County the fevers were of the inter- 
mittent or continued forms. Typical typhoid fever was 
rarely observed. The special eruption, diarrhoea and 
temperature were generally absent. It is a singular 
observation of the reporter that persons exposed to 
severe and drenching rainstorms were rendered particu- 
larly liable to attacks of intermittent fever ; and also that 
the first stage of the fever was often omitted. Scarlet 
fever has evidently not been common. Dr. Pugh thinks 
the idiosyncrasy of the individual determines the malig- 
nancy of this fever, rather than the materium mcrbi. A 
few cases were met with in Beverly, supposed to have 
been occasioned by sewer gas. Mumps appeared epi- 
demically throughout the district. Measles and whoop- 
ing-cough occurred frequently in many of the towns. 
Diarrhoea, cholera morbus and cholera infantum were the 
principal diseases of July and August, Cholera morbus 
required immediate attention or the patient would recover 
without the physician's aid. Improper food was the 
provocative cause of digestive troubles with the children. 
A few of first cases of cholera infantum proved speedily 
fatal. Diphtheria was met with in a few instances in 
Moorcstown during October and November, In Mount 
Holly it was more severe, displapng a malignant charac- 
ter. Us orii;in was attributed to defective drainage. 

llUistralivo of the difficulty in recognizing diphtheritic 
croup, as well as its fatality, the reporter makes mention 
of a little patient which, though ill for two or three days 
hoforc with a suffocative cou^h, did not exhibit the diph- 
theritic exudation until the dav of death. WTiere the 



REPORT OF STANDING COMMITTEE. 1 39 

exudation began is a query. Its extension into the 
pharynx and bronchi was wonderfully rapid. 

One case of confluent variola occurred in September in 
an adult who had been vaccinated twenty-five years 
before. Many. of the pustules evinced malignancy in the 
disease. It did not spread beyond several vaccinated 
members of his family, in whom it manifested itself in a 
mild form. Great difficulty was met by the reporter in 
effecting vaccinia among children. • 

In the report from Camden County, the medical his- 
tory of the year is very complete. The summer was one 
of decided health. There were few cases of diarrhoea and 
cholera infantum in the City of Camden. Dr. Godfrey 
believes that the term cholera infantum is often used too 
comprehensively, and is a misnomer in the absence of a 
copious watery flux, attended with vomiting and emacia- 
tion. Through the county the usual summer complaints 
were found, though none in a severe form, and all 
promptly yielded to treatment. Malaria has been ever 
present, exhibiting itself in protean forms, everywhere 
modifying existing diseases and always requiring that 
peculiar specific, quinine, for its control. In Camden it 
assumed the phenomenal form of jaundice, and prevailed 
thus epidemically. Plain intermittents and remittents 
have occurred in each month in the year, though not to 
one-half the extent they have in several previous years. 
Whooping-cough was the only other ailment that 
approached the character of an epidemic. Scarlet fever 
and diphtheria were frequently met with, but no mortality 
accompanied them. The former, however, was more 
severe in Gloucester City, in which locality typho-malarial 
and intermittent fevers prevailed epidemically. Typhoid 
fever, so general in former years, has been much less fre- 



I40 MEDICAL SOCIETY OF NEW JERSEY. 

quent, and when met with it has been in a mild form with 
few complications. Measles, bronchitis, pneumonia, ton- 
sillitis and rheumatism were customary during the winter. 
From Haddonfield, Dr. Jennings reports the usual 
amount of those affections which always obtain pre- 
eminence there through malarial influences. None have 
appeared in an epidemic form, and there has been no 
typhoid fever. He states that quinine cures everything. 
In Blackwoodtown there has been a freedom from epi- 
demic influences, with the single exception of measles, 
since the first of the year, with a mortality-rate lower 
than for several years. From May to October, of some 
isolated cases of scarlet fever, one malignant case ended 
fatally. During the last two of these months an occa- 
sional case of diphtheria occurred, with no deaths. 
There was the ordinary trouble with the air passages in 
the winter. Several instances of pneumonia in the month 
of September was a rare observation in Dr. Branin's 
practice. Two cases of typhus fever were taken to the 
alms-house at Blackwoodtown ; both recovered. An 
extension of the disease was prevented by rigid isolation. 
Dysentery of a grave form was prevalent in the town of 
Winslow during the summer. This disease has prevailed 
in that vicinity on several previous occasions, and is 
uAdoubtedly due to a want of care in sanitary matters. 
Not a single case of pneumonia presented itself to the 
profession in the neighborhoods of Waterford and Win- 
slow, while, during the continuously cloudy and damp 
weather of winter and spring, rheumatism, pharyngitis, 
lar>Migitis, tracheitis and bronchitis were abundant. 
Scarcely a family escaped one or more of these com- 
plaints. Bronchitis was at times very stubborn. Of the 
955 patients treated at the Camden City Dispensary, fully 
two-thirds were reported due to malarial influences and 
ordinary colds. 



REPORT OF STANDING COMMITTEE. 14I 

In Cape May County the death-rate has been lower 
than that of any other county. The people seem pecu- 
liarly favored in the small amount of sickness found 
among them and in accompanying scanty mortality. 
There has been a general immunity from epidemics of 
every kind, with the exception of a moderately severe one 
of scarlet fever during the winter and spring of 1883 in 
Tuckahoe, which continued into the month of May. 
Many of those attacked with the fever were left with 
troublesome sequelae. It broke out again last fall and 
early winter in a milder form. About the same time a 
few sporadic cases were met with along the bay shore, 
with no deaths. A few scattered cases of diphtheria, 
chicken-pox, whooping-cough and mumps occasionally 
appeared. Intermittent and remittent fevers have been 
fewer than for many years. Typhoid fever has been rare. 
In the summer there was an unwonted deficiency in bowel 
affections, both in children and in adults. Catarrhal 
pneumonia, acute bronchitis and the customary influenza 
were the effects of the protracted raw, damp weather 
consequent upon the breaking up of winter. The year 
has been exceptional in the general health of the county. 

In Cumberland County the reporter expresses spe- 
cial gratification at the steady decline, during the last five 
years, in the number of fatal cases of consumption. In 
1879 ^^^ number was 160, which has decreased at a rather 
steady rate to 90 for the past year. Those who may read 
the report will observe the reasons he assigns for this 
decidedly pleasing change. The entire amount of sick- 
ness was much less than in former years ; the number of 
deaths 14.59 P^^ thousand, to 20.94 per thousand of last 
year. Measles were the only noticeable endemic. The 
summer complaints of children were much less severe 



142 MEDICAL SOCIETY OF NEW JERSEY. 

than is usual, the mortality being twenty five per cent- 
less. Catarrhal affections were those chiefly observed 
during the winter, while the entire county has been 
strikingly free from diseases of any serious import. 
Strong objections are offered against classing croup and 
diphtheria together under one head by the compilers of 
our mortuary statistics. Dr. Ingram thinks the habit 
cannot be made a correct one by any amount of authority 
or of persistency in the practice. Accurate weather 
statistics accompany this report. 

The health of ESSEX COUNTY has been remarkably 
good. Far less sickness than usual is reported from all 
sections of the county, so that the busiest physicians 
have now uncommon leisure. Typhoid fever, which has 
been inclined to increase for a number of years before, 
was of rare occurrence. There were no epidemics of the 
eruptive fevers except in the northern portion of Mont- 
clair ; measles ran mildly through the families whose 
children attended the district school slnd in the town of 
Fairfield, into which they were imported in February from 
Paterson, and were quite general. Diarrhoeal and mala- 
rial diseases have not maintained the prominence which 
they have heretofore held, malaria being unmentioned 
except in the northern part of Bloomfield, through which 
the Morris canal runs. There was much whooping-cough, 
follicular tonsillitis and catarrhal pneumonia ; but the 
characteristic feature of all these diseases was their com- 
parative mildness. Rheumatism and the affections 
originating therefrom were seldom of the acute grade, yet 
required pretty full doses of the salicylates in their treat- 
ment. Iodoform has been for some time the pre-eminent 
dressing for wounds in the hospitals. It is now being 
superseded by the more fashionable bi-chloride solution. 



REPORT OF STANDING COMMITTEE. I43 

In the treatment of diphtheria this solution acts nicely as 
a spray for the throat. 

In Orange and Newark, diphtheria occurred during the 
winter, of marked malignancy, originating from some 
local causes. Tracheotomy was often done on the exten- 
sion of the membrane into the larynx and trachea, and 
was uniformly unsatisfactory beyond affording temporary 
relief except one case, in which the tube has been in- 
serted for one week, and the little two-year-old patient 
is almost well. When the true diphtheritic membrane 
covers the tonsils and pharynx and extends down into 
the larynx, Dr. McDermott regards the case as one of 
diphtheritic croup. Should the child die from mechanical 
obstruction, with no false membrane appearing in the 
throat, it is croupous laryngitis or true membraneous 
croup. He believes them to be two entirely distinct dis- 
eases. Some interesting statements are made in the 
report by Dr. Love, in reference to the treatment of 
puerperal fever. As a. result of his experience, whenever 
a case presents itself now he immediately begins the use 
of salicylic acid, and invariably with good results. He 
continues the medicine for several days after all signs of 
the fever have abated. 

Two trials of rectal anesthesia have been made in the 
hospitals in Orange and Newark — one in the case of an 
adult for amputation of the finger in traumatic gangrene, 
the other in osteotomy of tibia, in a child three years of 
age. In consideration of these and other reported cases, 
we may summarize the advantages and disadvantages of 
this mode of administration of an anaesthetic in the 
reporter's own words, as follows : 

*• Advantages — 

(i) No disagreeable sense of suffocation. 



144 MEDICAL SOCIETY OF NEW JERSEY. 

(2) No subsequent nausea. 

(3) Operations on the face unimpeded. 

The disadvantages are — 

(i) The danger of giving an overdose. Large quan- 
tities of the gas may be retained in and ab- 
sorbed by the intestines after the withdrawal 
of the rectal tube. 

(2) The prolonged subsequent prostration. 

(3) The frequent occurrence of severe intestinal irri- 

tation. 

It is perhaps too soon to say that these objections are 
insuperable ; but, unless some way to obviate them is 
speedily devised, the era of rectal anaesthesia will be 
short.*' 

Gloucester County reports the general health some- 
what better than for the two preceding years. No malig- 
nant epidemics have appeared anywhere. The usual 
acute diseases were quite governable. There were many 
deaths among the aged. Mumps, measles, tonsillitis and 
scarlet fever were occasionally observed in several locali- 
ties, more particularly in Bridgeport. This spring there 
was an extensive epidemic of ulcerated sorethroat, 
affecting the entire county. In some instances the febrile 
symptoms appeared quite prominent. Abscess of the 
throat was the only sequela, and this one very rare. All 
fully recovered after an average duration of one week. 
Cholera infantum, when seen in this district, is usually 
contracted elsewhere. Dr. Buckingham mentions several 
instances of an exceptional fever in Clayton very like 
scarlatina, still differing from it in some inexplicable way, 
as the patients contracted scarlet fever afterward. Mala- 
ria was present in every season through the year. It was 



REPORT OF STANDING COMMITTEE. I45 

particularly annoying as a complication, insinuating itself 
into all conditions and showing its hydra head in every 
conceivable form. It is as a complication with another 
disease that it is most difficult of management. 

In Hudson County the past year has been remarkable 
for the general healthfulness of the people. The death- 
rate is found to be much below that of former years. 
The distinctive diseases of last summer were greatly 
ameliorated by the charming weather. A change in the 
source of the water supply for Hoboken tended also to 
promote greatly the health of that city. It is now 
obtained from the Hackensack ; formerly it came from 
the Passaic river. In commenting upon the comparative 
death-rate of Hudson with other counties, the reporter 
notes an element which very much increases it in Hud- 
son, and that is not equally applicable to any of the 
others. He refers to accidents of such a nature as may 
occasion death at once or in a short time. Those con- 
nected with the great railroads of the State, all of which 
terminate, here, with their hosts of tracks^ switches and 
bulkheads; also the immense shipping interests extending 
for miles, furnish numerous accidents. 

Hunterdon County has experienced mild epidemics 
in nearly every section. Periodical fevers have been less 
in number than for several years past, while there has 
been more than the average number of cases of phthisis. 
Influenza appeared as early as January, and continued 
through to April. In Perryville it was particularly obsti- 
nate. A severe form of scarlet fever began in Muscanet- 
cong valley about the first of March. Measles, whooping- 
cough and mumps were prevalent. In Lambertville 
there was an unusual number of cases of jaundice among 
10 



146 MEDICAL SOCIETY OF NEW JERSEY. 

children. Pneumonia and rheumatism were met with in 
some places, but not of unusual severity. In Flemingtpn 
and Perryville, bronchitis was frequently observed. In 
the latter place it assumed a typhoid type. Of typhoid 
fever, only a few cases have been seen. Cancer was 
uncommonly frequent in Dr. Little's practice in Blooms- 
bury. The Doctor queries whether it occurs as exten- 
sively outside of the Muscanetcong valley. Neuralgias 
have been more common than fevers — most probably 
another phase of the malarial poison. The reporter 
states, moreover, that diseases of the nervous system 
have been numerous. He believes that these affections 
are on the increase. 

Mercer County has been more than usually healthy 
for the past year. Measles prevailed epidemically in 
South Trenton and Chambersburg during the latter part 
of winter and early spring. Some of the cases were com- 
plicated with catarrhal bronchitis and a few with pneu- 
monia. Diphtheria and scarlet fever were current in the 
form of sporadic cases pretty much the entire year, 
though no epidemic has prevailed. Many of the cases 
were unusually severe, and fatal in not a few instances. 
Periodical fevers hSive been less prevalent until within the 
past few weeks. The cases which have occurred recently 
have shown, in many instances, marked tendency to cere- 
bral congestion and other manifestations of a severe type. 
Diseases of the air passages of the customary amount 
were encountered during the fall and winter months, 
though the mortality was perhaps below the average. 
The ordinary intestinal troubles of summer were neither 
unusually frequent or severe. Dysentery prevailed more 
extensively than for many years in Trenton among adults. 
The severity of the latter disease was noticeable, and 



REPORT OF STANDING COMMITTEE. I47 

many instances proved fatal by reason of hemorrhage or 
other complications. Mumps were general through the 
city. Orchitis complicated a large number of the cases. 
In some the orchitis appeared first, and the enlargement 
of the parotid was not observed until a few days later. 
An annual return of diphtheria is reported in Hopewell. 
In the early part of 1883 it was quite severe and fatal. 
The extraordinary amount of snow and rainfall hastened 
its entire disappearance at the beginning of this year. 
The meetings of the District Society are represented 
as growing in interest and in the attendance of the mem- 
bership since the discussions upon ethical subjects have 
given place to the more profitable discussions upon medi- 
cal subjects and of interesting cases reported. 

Middlesex C^ounty. — The condition of health in this 
county has been good. The epidemics have been mild 
in character, except one of diphtheria in New Brunswick 
in November and December. A large number of deaths 
resulted therefrom, the greater portion of which were in 
consequence of laryngeal complications. The disease 
continues to the present time in a much subdued form. 
In Washington, South River, Sayresville and Dayton, 
measles were prevalent. Pneumonia and pleurisy were 
common in the winter. Cholera morbus and dysentery 
in the summer were met with in less than their usual 
frequency. 

There have been many sporadic cases of cerebro-spinal 
meningitis during the past two years in South Brunswick. 
Adults and children were equally affected. The disease 
displayed itself at times as an idiopathic malady, and 
again as a complication of some other disease. It was 
such in a considerable number of cases of mumps — more 
often even than orchitis — and required large doses of the 



148 MEDICAL SOCIETY OF NEW JERSEY. 

bromides. The reporter believes it is caused by a specific 
kind of malaria, over which the bromides exert a control. 
He also thinks the malarial poison producing remittent 
fever is of a different kind from that producing intermit- 
tent fever, and gives his reasons at length. One of the 
peculiar features of cerebro-spinal meningitis is the 
inflammation of the bowels or of the lungs, or acute 
gastritis with vomiting. " These diseases were more 
apparent than real, as a large percentage of the cases 
were entirely relieved by the bromides and quinia." 

Intermittents appeared casually in Woodbridge, Perth 
Amboy and South Amboy. In New Brunswick they 
were more often observed on the outskirts of the city, 
and in low, moist localities. 

A disease called the winter cholera prevails at the 
present time upon Little Rocky Hill. Ifs attack is sud- 
den, and it spreads rapidly through the families which it 
assails. The disease has existed there before in the 
spring of the year, and is due to some peculiarity of the 
water supply, which is largely surface water in the wells. 

Monmouth County has been free from epidemics. 
There has been little out of the ordinary course of sick- 
ness in any portion. No contagious disease has prevailed, 
except measles, in the vicinity of Port Monmouth and 
Keyport. At Freehold there were a few cases ; the first 
seen in that town for twelve years. Dr. Welch mentions 
a curious instance, illustrating the very dangerous charac- 
ter of measles when immediately following a pre-existing 
disease. A little girl, two years of age, who passed suc- 
cessfully through virulent attacks of scarlet fever and 
diphtheria in February and March of last year, only to 
die on the third day of an attack of measles in the June 
following. Diseases of the respiratory organs were less 



REPORT OF STANDING COMMITTEE. I49 

severe and more amenable to treatment. Bronchitis was 
observed chiefly as a complication of measles. Intestinal 
complaints were few. Dr. Thompson states : " In Ocean 
Beach, since the ist of May, 1878, from among a summer 
population of 5,000 and a winter population of 400, there 
have been only three deaths of children, and only twenty, 
five deaths in all." He reports, also, that skin diseases 
were more prevalent than usual, and that since March ist 
a number of cases of acute rheumatism occurred, which 
yielded promptly to oil of gaultheria and alkalies. 
Typhoid fever was common in different parts of the 
county during the autumn. 

Morris County. — Reports from Morristown, Mend- 
ham, Middle Valley, Baskingridge, Dover, Succasunna 
and Bloomingdale, prove the year to have been a singu- 
larly healthy one. Pneumonia was reported one year ago 
as a severe epidemic at Madison and Morristown. Since 
that time it has scarcely been observed, while at Bask- 
ingridge and Mendham it was quite prevalent. In these 
towns, scarlet fever and diphtheria were met with to a 
limited extent. In Morristown and Middle Valley they 
appeared so mild and irregular in form as to make the 
diagnosis of the larger number of them uncertain. 
Measles and whooping-cough were epidemic in Blooming- 
dale. Dr. Farrow notes a large number of intermittent 
neuralgias. 

In Ocean County there were only a few sporadic 
cases of the more serious diseases. Of typhoid fever 
there was less than for the three previous years. Scarlet 
fever and whooping-cough were uncommon. A mild epi- 
demic of diphtheria occurred at Cedar Run. Mumps were 
epidemic in some sections, and measles were everywhere 



150 MEDICAL SOCIETY OF NEW JERSEY. 

prevalent, mostly of a mild type. Pneumonia and bron- 
chitis were quite frequent. Several of the cases of 
pneumonia were severe. There were a great many deaths 
during the year from phthisis. Two cases of tetanus are 
reported ; both proved fatal. 

In Passaic County our reports are based chiefly upon 
communications received from the City of Paterson, 
which was visited by a less amount than usual of the 
various forms of malarial fever. Of the intermittent 
forms, the tertian was probably the most common. The 
tendency for neuralgia and inflammatory affections to 
complicate with malaria was less noticeable, although the 
disposition to intermit is present at times. Many of the 
remittents were distinguished by very high temperatures. 
Affections of the respiratory organs occurred with more 
than the usual frequency. In December and January 
there were many severe cases of pneumonia, which often 
proved fatal. Bronchitis was also common through the 
winter. These two diseases were often complications in 
an epidemic of measles, from which fifteen deaths were 
reported. Typhoid fever occurred throughout the year, 
but there was probably less of this fever than in either of 
the two years just preceding. The public wells in the 
city, upon which so many rely for drinking water, are 
believed to be the cause of many cases of continued fever. 

The various intestinal diseases were much less preva- 
lent during the past summer than formerly. Dysentery 
was observed occasionally by several physicians in the 
winter and spring. The reporter met with two genuine 
cases of dysentery in January, which resisted with re- 
markable obstinacy the treatment employed. It is 
thought there were fewer cases of diphtheria than usual ; 
113 were reported to the Board of Health, with 36 deaths 



REPORT OF STANDING COMMITTEE. 151 

distributed through each month of the year. Scarlet 
fever was met with in various parts of the city in a mild 
form ; 506 cases were reported, with 69 deaths. 

Salem County has not suffered from any epidemic of 
severe form. There was an unusual freedom from disease. 
Those that did occur were simply such as attend the 
seasons, this spring being in decidedly favorable contrast 
with the last. There was a gefteral decline of periodical 
fevers through the county. Articular rheumatism was 
quite prevalent, a good many children being among the 
number affected. Diarrhoeal diseases were not observed 
to the extent usual in this district, and the mortality was 
not so great as during the previous year. This the 
reporter thinks the more remarkable, as the increased use 
of the water furnished by the new water-works might be 
justly expected, by its seeming impurity, to increase 
bowel troubles. This water is obtained from a pond 
with a mud bottom, yet, with its frequent use for all 
purposes last summer, no sickness was ascribed to it as a 
source. A considerable number of cases of mumps and 
measles were met with in every section. Diphtheria and 
scarlet fever were rare. 

Somerset County has been free from disease in severe 
form or of an epidemic nature. 

In Sussex County the year has been one of extra- 
ordinary healthfulness. There were no epidemics. Dr. 
Allen, of Lafayette, states that he has never known so 
healthy a season in forty years. There was a decided 
absence of intensity in the sickness that did occur. The 
usual malarial diseases were of less amount than in the 
two preceding years. Even in Andover, a neighborhood 



152 MEDICAL SOCIETY OF NEW JERSEY. 

nearly always laden with malaria, there was. much less 
than the average sickness. In the autumn a few cases of 
cerebro-spinal meningitis were encountered, following a 
mild form of remittent fever. A peculiarity of this 
malady was a permanent contraction of the muscles of 
the right side of the body, the head being drawn and 
fixed at an angle with the spinal column. This position 
was maintained in the fatal cases, paralysis and death 
rapidly following. 

The short report from Union County informs us that 
there has been a general immunity the past year from any 
decided epidemic influences. 

Warren County has been exempt from any distinct- 
ively prevalent disease, and there is little that calls for 
special notice. Dr. Hulshizer mentions a few cases of 
scarlet fever which occurred in two families in an isolated 
locality, whose members had not visited each other for 
some time or been absent from home. He believes them 
clear cases of spontaneous contraction. We have only 
to notice, farther, acute inflammatory rheumatism in 
Phillipsburg and its vicinity. Several deaths resulted 
from involvement of the heart. 

In review of the reports, we may sum up the medical 
history of the year as follows : 

1st. A diminished amount of disease throughout the 
State. 

2d. Epidemics have not prevailed to any great extent, 
and were of diminished intensity. 

3d. Diseases of the respiratory organs, though com- 
mon, were observed in less severe forms, and were more 
than usually amenable to treatment. 



REPORT OF STANDING COMMITTEE. 1 53 

4th. An extraordinary freedom from diseases of the 
intestinal canal. 

5th. Less scarlatina, diphtheria and other contagious 
diseases except measles, which were unusually prevalent. 

6th. Fevers, which always call for a large share of pro- 
fessional attention, have nowhere shown a marked fatal 
tendency. 

TREATMENT OF DISEASE. 

We note some of the observations in the reports upon 
the therapeutics of disease. 

There is a growing disposition to give quinia in very 
large doses. Dr. Hulshizer says sure success lies only in 
heroic doses. Of all the ways in which quinine may be 
taken, the Doctor, from experience, recommends the 
powder as the easiest, taken in any sour juice — as cherry 
juice — and drank with water. 

Dr. Way, of Seaville, has been uniformly successful in 
the treatment of rheumatism with the salicylate of soda. 
Dr. Griffith, of Phillipsburg, is inclined to think the sali- 
cylates are contraindicated in a second attack of acute 
rheumatism. Dr. Simpson prescribes with much satisfac- 
tion in a number of cases of inflammatory rheumatism, 
aconite and bryonia in small doses, together with the 
wine of colchicum and carbonate of ammonia. Several 
physicians have derived great benefit from the frequent 
and thorough local use of lime water through the atomi- 
zer in diphtheria, in conjunction with, of course, the 
appropriate medicinal treatment. Dr. Oliphant, by this 
means, succeeded in expelling the false membrane from 
the larynx in true croup. Dr. Turnure placed his patient 
with croup under a tent in a room brought to the tem- 
perature of 80*^ by steam from boiling water and slacking 
lime. The child was kept in this atmosphere of steam 



154 MEDICAL SOCIETY OF NEW JERSEY. 

for ten days, and finally nnade a good recovery. The 
yellow sulphate of mercury was used as an emetic when 
the membrane seemed to encroach upon the calibre of 
the larynx. Genuine diphtheria Dn Currie controlled 
best by means of a dilute solution of chloride of sodium 
up the nares, and large doses of tincture of iron — ten to 
forty drops every half hour or hour, according to age. 
Of all the therapeutic resources that have been drawn 
upon in the treatment of diphtheria, if he were compelled 
to choose one, Dr. Thornton would select alcohol. He 
has tried whiskey and milk without other medicine, 
locally or generally, and believes it efficient. 

In a severe case of congestive chill, Dr. Morris, pro- 
ceeded at once to open a vein. A flow of blood was at 
first obtained with difficulty. After drawing off five 
ounces it came more freely, and after taking twelve 
ounces reaction set in, terminating in a speedy and good 
recovery, with the moderate use of quinine. The 
reporter of Bergen County adopted a plan of treatment 
in pneumonia that has given him better results than any 
other he has ever tried. He had, during the year, more 
than the average number of cases on his hands. In all of 
them he used aconite in small and frequently-repeated 
doses during the first stage, with hot fomentations and 
anodynes, if needed for pain, and small doses of phos- 
phorus in the second stage. 

An intelligent observer in Monmouth County has often 
seen the happiest effect from large doses of digitalis in 
typhoid fever, small doses being perfectly futile, while 
large doses, to the extent of a teaspoonful of the tincture, 
have calmed delirium and induced refreshing slumber. It 
reduced the pulse and, to some extent, the temperature. 
He has never met with the cumulative effect spoken of 
by writers, though his use of it in fevers, cardiac diseases, 



REPORT OF STANDING COMMITTEE. 1 55 

and in two cases of delirium tremens where doses of 
one-half ounce were used, gave him abundant opportunity 
to study the action of the drug. 

INTERESTING CASES. 

Dr. Downs reports a case of encephaloid disease of the 
omentum, as it proved to be at the autopsy. Various 
opinions had been given by different physicians during 
his long illness of six years. Severe symptoms in the 
region of the heart at one time seemed to establish the 
opinion that some organic affection of that organ was the 
cause ; at another time, marked symptoms of indigestion 
pointed towards the stomach as the seat of the trouble ; 
again, for a short period, acute mania confused the diag- 
nosis and directed the attention naturally to the brain as 
the probable seat. After death the omentum was found 
enormously thickened. The vital organs were found 
normal. 

Dr. Miller reports a case of senile gangrene, occurring 
in a man eighty years of age. On his first visit he found 
his patient in feeble health and suffering with acute pain 
in the left foot ; the skin of the toes black, cold and 
insensible, the ankle and instep swollen, and the sur- 
rounding tissues infiltrated. In time, all the toes dropped 
off except the small one, followed by healthy granula- 
tions. All the stumps healed kindly. The foot is now 
perfectly well, the health and strength good, and the old 
man, after fifteen months of illness, is able to walk a mile 
or two without fatigue. 

It is undoubtedly true that scarlet fever may occur 
more than once in the same individual, but the same 
physician very rarely attends the second time upon the 
same patient. Dr. Phillips attended a genuine case of 
scarlet fever of the anginose type this winter. The 



156 MEDICAL SOCIETY OF NEW JERSEY. 

Doctor treated her in an attack of the same kind when 
eight years of age. Both attacks were so well defined as 
to be unmistakable. 

An anomalous case of abscesses is reported by Dr. 
Carll. Two were located in the region along the line or 
between the folds of the colon, the third and last one 
between the diaphragm and the upper surface of the 
liver. The first two discharged themselves through the 
colon, and were each followed by three or four weeks of 
a typhoid stage. The last one found an exit through the 
right lung, the discharge continuing thus for six or seven 
weeks, followed by convalescence. 

Dr. Barker reports a case of pneumonia accompanied 
by great cardiac depression. During the first week the 
temperature was loi^ to 103^ in the axilla ; in the mouth 
it was 97^. After convalescence the buccal temperature 
gradually rallied to the point of that in the axilla. 

A hydrocele was radically cured by Dr. Condict, after 
the method of Prof. Levis. Upon evacuating the fluid 
the sac was injected with a drachm of liquified carbolic 
acid. The patient attended to his ordinary labor the 
next day. 

The following papers have been received with the 
reports : 

A paper on ** A New Mode of Malarial Poisoning," by 
Dr. Stickler, of Orange. 

A paper on " The Artificial Alimentation of Infants," 
by Dr. Turnure, of Bergen County. 

Report of an epidemic of scarlet fever and ulcerated 
sore throat at Bridgeport, Gloucester County, by Dr. 
Oliphant. 

A paper on " Homoeopathic Remedies,** by Dr. John 
R. Stephenson, of Camden County. 

A paper on " Blood-letting,** by Dr. Frederic Morris, 



REPORT OF STANDING COMMITTEE. 1 57 

of Bergen County. A lost art which, for the good of the 
patient, it might be well at times to regain. 

A case of annular disease of the ear — a sequel of 
mumps, remarkable for the insidiousness of the attack 
and its gravity, by Dr. Chambers, of East Orange. 

A case of chorea by Dr. Clark, of St. Barnabas* Hos- 
pital 

A case of ovulation without menstruation, by Dr. 

Shannon, of Hunterdon County. 

An acute case of Bright*s disease, by Dr. Thompson. 

Brief histories of several interesting cases, by Dr. 
.Welch, of Key port. 

A case of diaphragmatic pleurisy, resulting in pyotho- 
rax and finally recovered, by Dr. McCray, of Camden. 

Dr. Marcy, of Riverton, sends a history of an extra- 
ordinary case illustrating that singular pathological con- 
dition — muscular hypertrophy of the stomach. 

ITEMS OF MEDICAL INTEREST. 

Under this heading we would notice the publication 
within the State of a new journal that is evidently des- 
tined to become permanent — the Archives of Pediatrics, 
It is the only journal devoted to the diseases of early 
childhood, and is worthy the attention of the profession. 
It is ably edited by Dr. Wm. P. Watson, of Jersey City. 

Clinical and practical instruction in the diagnosis and 
treatment of diseases of the eye and ear were given to a 
considerable number of medical practitioners and stu- 
dents through the year at the Newark Eye and Ear 
Infirmary, by one of our esteemed Vice-Presidents, Dr. 
Charles J. Kipp. The opportunities afforded at the 
Infirmary for the study of these special branches is not 
surpassed anywhere. 

We would also state that Dr. Kipp has been appointed 



158 MEDICAL SOCIETY OF NEW JERSEY. 

one of the editors of the Archives of Otology^ a quarterly- 
journal published in English and German. 

The Society for the Relief of Widows and Orphans of 
Medical Men of New Jersey is flourishing. It is estab- 
lished on a firm basis, and deserves to have a larger mem- 
bership than it has yet attained. 

The Burlington County Hospital, at Mount Holly, has 
been in successful operation over four years. It is con- 
ducted on the cottage plan. 

The Hospital for Women and Children, which was 
opened a year ago in connection with the Home for the 
Friendless, in Newark, has been discontinued. 

It will be observed, from what is said in the report from 
Essex County concerning the Newark City Home, located 
at Verona, and in which are domiciled about 180 children, 
how essential is a pure water supply for the health of 
public institutions. 

A new hospital was opened in Newark last year. It is 
owned by the city, and is known as the City Hospital. 
It is under the management of a board of directors 
appointed by the mayor, and can accommodate about 
sixty patients. 

The Hospital of St. Barnabas, at Newark, is to be 
greatly enlarged. The corner-stone of the new building 
was laid a few days ago. 

T. J. SMITH, 
E. J. MARSH, 
S. S. CLARK, 

Standing Committee, 



APPENDIX 

TO 

REPORT OF STANDING COMMITTEE 



fin Mtmoviam. 



B. RUSH BATEMAN, M. D., 

Born March 7, 1807. 
Died July 23, 1883. 



JOHN A. ROGERS, M. D., 

* Born January 7, 1852. 
Died December 30, 1883. 



LEWIS MACKEY OSMUN, M. D., 

Born November 2, 1835. 
Died March 20, 1884. 



JAMES CLARK FITCH, M. D.. 

Born November 7, 1792. 
Died March 22, 1884. 



11 



OBITUARIES. 



• ♦• 



B. RUSH BATEMAN, M. D. 

BY E. R. BATEMAN, M. D., OF CEDARVILLE, N. J. 

Dr. B. Rush Bateman died at his residence in Cedarville, Cumber- 
land County, New Jersey, July 23d, 1883, in the 77th year of his age. 

He was born March 7th, 1807, and was the son of Dr. Ephraim 
Bateman, who resided at Cedarville and practiced extensively through- 
out the townships of Fairfield and Downs from 1803 to 1813, and 
subsequently served for twelve years in the New Jersey Legislature 
and United States House of Representatives and Senate. He was 
also a cousin of Newtqn Bateman, LL. D., whose phenomenal labors 
in the cause of education and public instruction have given him wide- 
spread celebrity. 

He entered upon the study of medicine in his father's office, and 
was graduated M. D. at the Jefferson Medical College in 1829. 
Among his classmates was the late Prof. S. D. Gross. After receiv- 
ing his degree he became a practitioner in his native village, where for 
more than half a century he continued in a most extensive and bene- 
ficent practice of his profession. His diploma, recorded in the 
Clerk's Office of Cumberland County, bears an earlier date than any 
other registered under the recently- enacted State law. 

Dr. Bateman was twice married. His first wife was Sarah A. 
Ogden ; his last wife, Ruth H. Mulford. By the former he had four 
children — two sons and two daughters. Upon both sons the ances- 
tral mantle fell, and they followed in the profession of their fathers. 
The one. Dr. Ephraim Bateman, is still in active practice at Cedar- 
ville ; the other, Dr. Robert M. Bateman (the father of the writer), 
practised for nearly seventeen years in Cedarville, when he removed 
to Bridgeton, N. J., where he died June 4th, 1878. 



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OBITUARIES. 165 

was formed in the village, in which he took an active part, was 
appointed an officer, and was the second one to sign the pledge. 

As a public man and citizen, he was respected and honored. Prior 
to and during the time of his medical studies, he held the position of 
postmaster in his native village. He was twice elected to the State 
Legislature. He held many positions of honor and trust in his 
township and county, and for a number of years, until a short time 
before his death, was the Secretary and Treasurer of the Bridgeton 
and Port Morris Railroad (now known as the Cumberland and Mau- 
rice River Railroad). 

Thus, full of years and good works, went he down to his grave, 
followed by a large concourse of relatives and friends who mourn his 
loss. 



JOHN A. ROGERS, M. D. 

BY DR. E. J. MARSH. 

Dr. John A. Rogers was bom in Paterson, N. J., on January 7th, 
1852, and died, after a short illness, on December 30th, 1883, in his 
native city. 

He was the son of Dr. Alexander W. Rogers, an ex-President of 
this Society. His early school education was obtained in Paterson. 
In 1869 he entered the University of the City of New York, and 
received the degree of Bachelor of Science from that institution in 
1872. He then commenced the study of medicine under his father's 
instruction, and attended lectures, and graduated at the College of 
Physicians and Surgeons in New York, in 1875. He entered at once 
upon professional work, assisting his father and obtaining a very con- 
siderable amount of practice of his own. In the autumn of 1880 he 
went to Europe and spent a )ear in the further study of his profes- 
sion, attending the hospitals of London, and the pathological demon- 
strations of Virchow in Berlin. In the summer of 1881 he was joined 
by his father, and together they were present at the meeting of the 
International Medical Congress, held in London. On his return 
home he resumed practice, and continued at work until his final 
illness. 



l66 MEDICAL SOCIETY OF NEW JERSEY. 

For five years he was Secretary of the County Medical Society, for 
several years physician to the Orphan Asylum, and for four years one 
of the assistant physicians of St. Joseph's Hospital, where, owing to 
the absence of Dr. Moss, he performed all the duties of an attending 
physician. All these positions of professional honor and responsibility 
he held up to the time of his death. 

Dr. Rogers, though still a young man, had obtained an enviable 
position in the esteem of the local profession and of the community. 
His medical learning and skill, accurate observation, professional 
spirit, and his clear and well-balanced mind, had gained him the 
respect of his fellow-physicians ; while his courteous, affable manners, 
unvaried good temper, kind and unselfish heart, won their affection. 
His numerous patients appreciated his devotion, sympathy and readi- 
ness to respond to their wants ; his large circle of social acquaint- 
ances found in him intelligent conversation, pleasant and unobtrusive 
manners, filial devotion and purity of character. To the writer he 
was all this, and more than can be here described. Esteem for an 
honorable physician and admiration for his personal character were 
united to an affection as for a younger brother. 

The funeral services were held in the First Baptist Church, and the 
large concourse of mourners — both professional and lay — was a 
testimony to this universal regard which he had inspired. 



DR. LEWIS MACKEY OSMUN. 

BY J. H. GRIFFITH, M. D. 

Dr. L. M. Osmun, one of the most prominent physicians of Warren 
County, N. J , died at his home in Phillipsburg shortly after five 
o'clock, March 20th, 1884, after suffering from an attack of rheuma- 
tism, which was the immediate cause of his death. Less than six 
months ago Dr. Osmun was enjoying excellent health. Within that 
period he gave a party to his friends at his beautiful residence on 
Main street, which he recently purchased and had remodeled. Who 
of the many present on that occasion would have supposed that to- 
day their esteemed friend would be cold in the embrace of death ? 

Dr. Osmun was the third son of Joseph and Elizabeth M. Osmun, 
and was born in Independence township, Warren County, N. J., on 



OBITUARIES. 167 

November 2d, 1835. In the spring of 1848 his parents moved to 
Prince William County, Va., where they continued their former avoca- 
tion of farming, the subject of this sketch diligently assisting them in 
all that pertained to the labor of the farm. In the meantime he took 
an academic course of instruction at Manassas Junction, after which 
he entered Columbia College, in Washington, D. C, where he had a 
partial course, and commenced the study of medicine with his uncle, 
L. C. Osmun, M. D., in his adopted county in 1856. After a due 
course of study with his uncle he entered the National Medical Col- 
lege Department of Columbia College, Washington, D. C, and after 
taking two full courses of lectures he graduated in the spring of i860. 
He soon after came North and located at Bushkill, Pike County, Pa., 
where he continued three years in an active practice, when, feeling a 
strong desire, in common with so many young surgeons of the North, 
to render all the assistance possible in putting down the late rebellion, 
he offered his services to the war department at Washington, and was 
immediately assigned to a position as assistant surgeon at Methodist 
Church Hospital, Alexandria, Va. After remaining there about four 
months he was transferred to Emdry Hospital, Washington, D. C, 
where he rendered very efficient service until August, 1865, when he 
again came North, located in Phillipsburg, and continued in a large 
and lucrative practice of medicine and surgery until removed by 
death. He made surgery a: specialty from the first, and at the time of 
his departure was the surgeon in this vicinity for the Central and 
Morris & Essex railroads. His success as a surgeon was undoubted. 
His treatment of a case was conservative rather than radical, and the 
best results followed nearly all of his operations. His rank as a sur- 
geon for the past twenty years had placed him among the leading 
medical men of this portion of New Jersey. He was highly appre- 
ciated by his fellow-practitioners in medicine, and he was a working 
member of the District Medical Society for the county of Warren. 
His generosity was of the first order, giving freely of his means to 
every humane and worthy purpose. He was firm in his decisions, but 
kindness and benevolence were seen in all his actions, especially 
among the poorer class of his patrons. 

Through careful and close attention to business. Dr. Osmun accu- 
mulated a competency said to be worth ^30,000. He was a thinker, 
and not afraid to express his opinions at all times. At the time of hi^ 
death he was a member of the Phillipsburg school board, and was 



1 68 MEDICAL SOCIETY OF NEW JERSEY. 

always deeply interested in the cause of education. No man in his 
profession morie enjoyed a joke than he ; and he could be found, when 
business permitted, at the different entertainments in the town, laugh- 
ing and joking with all with whom he came in contact. He was 
never married. " Don't forget," said a Phillipsburger from whom we 
obtained a part of Dr. Osmun's history, " to say that no class of 
people in the town can better testify to his reputation as a charitable 
citizen than the business men, many of whom, from time to time, 
received large orders for groceries to. be distributed among the poor 
and needy." 

The deceased was a member of Delaware Lodge No 52, F. and A. 
M. ; Eagle Chapter No. 30, R. A. M. ; DeMoley Commandery, 
Knights Templar, of Washington, N. J. ; Ancient Order of United 
Workmen ; Treasurer of the Knights of Honor, and Vice-President 
of the Lehigh Valley Medical Society. His mother, two brothers and 
two sisters survive him. The former lives with her daughter, Mrs. P. 
W. Skinner, in Phillipsburg. The other sister is the wife of Dr. A. 
H. Lee. His brothers. Dr. L. C. Osmun and Jeremiah Osmun, the 
latter a farmer, live at Delaware Station. . 

The funeral took place on Monday afternoon at 2 o'clock, March 
24th, 1884, at the Presbyterian Church, Phillipsburg, and was one of 
the largest ever held in Phillipsburg. Revs. Townsend and Dickinson 
officiated. A large number of Knights Templar from DeMoley Com- 
mandery, of Washington, and Hugh DePayen Commandery, of Eas- 
ton, attended, accompanied by the Bethlehem brass band. 



JAMES CLARK FITCH, M. D. 

BY J. H. GRIFFITH, M. D. 

The subject of this brief sketch was born at Greensburgh, West- 
chester County, N. Y., November 7th, 1792, his father being a captain 
of a vessel engaged in trade with the West Indies. 

Most of his education was received at the Hudson Academy, while 
his parents resided at Canaan. In the year 18 16 he removed to War- 
wick, Orange County, N. Y., remaining nine years, during which time 



OBITUARIES. 169 

he taught school at Sugar Loaf and Warwick, studying his profession 
with Dr. Youngs. 

The winters of 1825 and 1826 were spent at the College of Physi- 
cians and Surgeons at Fairfield, Herkimer County, N. Y.. receiving 
his diploma in January, 1826. In the spring of the same year he 
returned to Warwick, and, after practising his profession at this place 
for one year, he removed to the town of Hope, Warren County, N. J., 
and in May, 1827, formed a partnership with Dr. Gideon Leeds, a 
physician of high repute who had a large and lucrative practice. 

They soon secured a practice which, for many years, extended over 
a large territory, and embraced the Paulins Kill valley from Columbia 
(including the mountains) to Stillwater, with all the intervening 
region as far east as Danville and beyond, traveling generally in those 
days on horseback. Such was the demand for their services that they 
were compelled to travel day and night. The partnership continued 
until a few years before the decease of Dr. Leeds. For more than 
fifty years Dr. Fitch practised medicine in the vicinity of Hope ; and 
no man ever sustained a higher reputation in the profession, and was 
for many years one of the oldest (if not the very oldest) practicing 
physician in the State. 

Of him it might have truly been said that he was a gentleman of 
the old school. As he honored his profession, so he honored himself 
in all the relations of life.* His integrity was inflexible. He continued 
in the practice of his profession, riding night and day, until the fall of 
1 88 1, when the grief at the loss of his wife, and his increasing feeble- 
ness and blindness, confined him to his house. For several years his 
family was unwilling to have him drive alone, and his daughter 
became his constant companion in storm and sunshine— by night as 
well as by day. 

He was married on the fourth day of July, 1831, to Miss Sarah 
Drake, who died October 24th, 1881. She had been a helpless para- 
lytic for nearly three years. The Doctor tried to bear up under this 
great grief with Christian fortitude, but it was too much ; and the 
once brilliant man, who was the life of every company, became silent 
and melancholy. The noble and generous heart was completely 
crushed. He was practically a total abstinence man, not using intoxi- 
cating drinks or tobacco for more than half a century. 

Four years before his death his eyesight was nearly perfect, and he 
was able to read both large and fine print without glasses, and his 



I/O MEDICAL SOCIETY OF NEW JERSEY. 

intellect was not in the least impaired up to this time. He had been 
in failing health for years, and when he fell he fell as the oak falls in 
the stillness of the forest. He was for many years the Nestor of the 
medical profession in Warren County, N. J. He was licensed by the 
State Medical Society of New Jersey in 1827, and became a member 
of the County Society in 1829. 

The Doctor was always a strict disciplinarian, neat in person, wear- 
ing the traditional black broad-cloth suit and silk hat. His reputation 
as an obstetrician was of the first order. It is said that he never cast 
a ballot without first lifting his hat, a custom that has become 
entirely extinct in these latter years. 

Two sons and a daughter, out of six children, survive him : Dr. 
George D. Fitch and Dr. Pelatiah Fitch, both residing in Philadelphia, 
Pa., and Miss Rosaline Fitch, who has always remained home with 
her parents, and who for years cared for those parents with a patience 
and devotion rarely equalled, and never excelled. 

His death occurred March 22d, 1884. The funeral took place on 
the 26th of the same month, at the Episcopal Church of the village 
of Hope, of which church the Doctor was a member. * A general 
invitation was given to the members of the District Medical Society 
for the County of Warren, and the members thereof responded with 
sad hearts. 



JOHN ALEXANDER SOMERVILLE, M. D. 

BY WM. H. O. TAYLOR, M. D. 

John Alexander Somerville, M. D., died on Thursday morning, 
April 3d, 1884, at his home in Union Hill, Hudson County, N. J. He 
was born in the City of New York on the first day of January, i860, 
and resided there until 1871, when his parents removed to Jersey City, 
N. J. Six years later, in 1877, his parents made their homtg in Union 
Hill, and there he resided until his death. 

His early education was commenced in the city of his birth, and 
was continued in Jersey City, where he entered the High School, from 
which he graduated on the twenty-seventh day of June, 1879. He 
at once commenced the study of medicine under the direction and 
supervision of Dr. H. T. Adams, of Jersey City Heights. In Septem- 



OBITUARIES. 171 

ber, 1879, he entered the Medical Department of the University of the 
City' of New York, where for three years he labored faithfully and 
earnestly to gain a thorough knowledge of the profession he expected 
to enter. He took his degree as Doctor in Medicine on the ninth day 
of March, 1882. Immediately after his graduation he opened an 
office at his home in Van Vorst place, Union Hill, N. J. Shortly after 
this, Smith, Ripley & Coleman, the contractors, of New York City 
(who were cutting the tunnel for the New York, West Shore and 
Buffalo Railroad from New Durham to the Hudson river, at Weehaw- 
ken), engaged him to attend all their employees in this vicinity. This 
gave him a good start, and soon his practice began to increase, and 
he gained deserved popularity. Families from the adjacent towns 
and villages sent for him, and would have no other physician. His 
time became fully occupied ; and as he gained in practice and popu- 
larity he lost his necessary rest, and failed in health. Shortly after 
the commencement of the present year he determined to take the 
needed rest, and started on a trip for health and recreation. But, 
alas, it was too late ; for, on reaching the home of a relative in New 
York City, he was taken ill, and returning home, took to the bed from 
which he was never again to rise. His constitution, naturally weak, 
was rendered more so by an obstinate form of malarial fever, which, 
for a long time, resisted medical treatment. When it commenced to 
decrease, rheumatism took its place. For weeks he endured the most 
excrutiating pain, and yet bore it in the most patient and uncomplain- 
ing manner. At times he seemed to be much better, and looked for- 
ward with great pleasure to the time when he could go about and 
resume his practice. The rheumatic pains increased toward the end 
of his illness, till within a short time before his death. Early on the 
morning of April 3d he asked for a drink of water, and, while in the 
act of raising it to his lips, he suddenly passed away to his everlasting 
rest. His funeral took place from his home on Sunday afternoon, 
April 6th, and was largely attended by all classes and conditions of 
society, the associations of which he was a member taking part in the 
exercises. His remains were laid to rest in Greenwood Cemetery. 

Dr. Somerville united with the Hudson County Medical Society 
soon after he commenced to practice, and continued an active mem- 
ber to the end of his life. Among both the rich and the poor he was 
universally beloved and respected, and many and bitter were the tears 
shed at the sudden cutting off of a promising life. He always main- 



1/2 MEDICAL SOCIETY OF NEW JERSEY. 

tained a cheerful and sympathetic demeanor in visiting the sick, 
giving encouragement to those who were despondent, and a kind 
word to the friendless. Among the poor he was especially kind ; and 
if he showed any more attention or kindness to one class of society 
than another it was to them, rather than to the rich. For one so 
young in years, his professional success is almost entirely unprece- 
dented. Yet he was not fond of declaring it ; in fact, he rather tried 
to avoid any allusion to it in public. 

To those of his professional brethren with whom he was associated 
from time to time he was always deferential ; still, if he thought that 
he was right in any case he held firmly to his opinion, but without giv- 
ing offence to any one. Whenever it was in his power, he was always 
ready and willing to do any one a kindness. When he died, the com- 
munity, his friends and his profession suffered a severe loss. In all 
his dealings, whether they related to business or social matters, he 
was honest, upright and painstaking, and his word was to be relied on 
in any emergency. Time will pass away rapidly, but it will be long 
before his memory will pass from the minds and affections of all who 
knew him ; and it will be long before one can be found who will, like 
the deceased, in so short a time, win the love and confidence of all 
with whom he becomes associated. Though he has passed away 
from us young in years, yet his memory remains to comfort those 
who are left behind to mourn, and to encourage those who are seeking 
success in the medical profession. 



DR. JOSEPH C. WEATHERBY. 

Dr. Joseph C. Weatherby, the senior practicing physician of Glou- 
cester County, was born in Clarksboro' in 1812, and died there April 
2Qth, 1884. 

Dr. Weatherby received his primar)* education in his native village, 
but at an early age he went to Kenyon College, at Gambier, Ohio, 
then under the care of the venerable Bishop Chase, where he was 
received as a member of his family by the Bishop, and spent several 
years most happily and profit:ibly in the pursuit of those liberal 
studies which so greatly and permanently influenced his later career. 



OBITUARIES. 173 

He was graduated in 1834, and, returning home, began to read medi- 
cine with Dr. Charles F. Clark, of Woodbury, and in due time 
entered the University of Pennsylvania, where he was graduated in 
1837. He opened his office at Clarksboro', and for forty-seven years 
continuously and most successfully practiced his chosen profession, 
with honor to himself and to the benefit of the community. In 1846 
the degree of Master of Arts was conferred upon him by the faculty 
of Kenyon College. 

In 1 841 he married Miss Henrietta Campbell, of Woodbury, a lady 
whose refined tastes, warm heart and earnest Christian character 
adorned his home for thirty-nine years. After her death, Dr. 
Weatherby was observed 10 fail gradually, but it was only during the 
last ten weeks of his life that he was confined to his house and room. 
Everything that medical skill and the care of his children could do was 
done, but it only availed to save him from great suffering, and not 
reluctantly, but in quiet and peaceful faith, he passed away. 

Dr. Weatherby was a notable man in every respect. Of large and 
ample frame, he was blessed throughout his life with unusually good 
physicial health. His temperate and regular habits, his extensive 
out-door exercise in the pursuit of his professional duties, added to 
his vigorous constitution, had this happy result. The same body was 
the casket of a sound and cheerful mind. His early studies had been 
a delight to him, and he kept them well up in his later years, and was 
heartily interested in the constant developments of science. While 
of a social disposition and fond of the society of his friends, he had 
such resources in himself that his many hours of solitary travel were 
not wearisome to him, and his life was eminently cheerful and con- 
tented. He was universally respected for his strict probity and 
honesty, and these were founded upon strong religious principles. 

For many years he was a member of the Episcopal Church, and 
served il faithfully as a vestryman, a delegate to conventions, and a 
member of the choir. His faith grew and deepened with advancing 
years ; and when the days of bereavement and sickness came, it is 
needless to say that it was more than able to uphold him. No cloud 
seemed to come between him and the God whom he had loved and 
served so long, and no word or sign of discontent at the Divine will, 
or of doubt or fear of the future, escaped him as he patiently and 
prayerfully awaited the end which he clearly foresaw. Too much 
praise cannot be given to his medical attendants. 



174 MEDICAL SOCIETY OF NEW JERSEY. 

For forty years, nearly, he was a member of the Gloucester 
County Medical Society, and was selected by that Society as their 
candidate for Third Vice-President of the State Society. The physi- 
cians of the county showed their fraternal regard for him during his 
sickness and by their large attendance at his funeral ; but Dr. Ash- 
craft, of Mullica Hill ; Dr. Laws, of Paulsboro', and Dr. Egbert, of 
Wayne, Penna., were unremitting in their skillful and affectionate 
attendance, and won the gratitude of all who loved him, by their 
devotion to him in the last months of his life. 

His funeral was most impressive. The church, which he loved, and 
which adjoins his house, was thronged to its utmost capacity, and had 
never held within its walls such a representative gathering of the 
people of the county. He has left a precious memory of strong 
Christian manhood, of a long and well-spent life in one of the noblest 
of callings, of fidelity and uprightness in all the relations of life, and 
at the right and appointed time has entered into rest. 



GENERAL JOHN M. CUYLER. 

BY GEO. W. CULLUM, BVT. MAJ. GEN., U. S. ARMY. 

Brevet Brigadier General John M. Cuyler, Surgeon (retired) U. S. 
Army, died at his residence in Morristown, N. J., on Saturday even- 
ing, April 26th, after a long illness, terminating in pyaemia. 

Gen. Cuyler was born March 9th, 18 10, in Savannah, Ga. His 
father was Judge Jeremiah Cuyler, a native of New York, and his 
mother was the grand-daughter of Gen. Latouche, of the French 
Army, in the reign of Louis XVI. One of his brothers was Richard 
Cuyler, for many years the president of the Central Railroad of 
Georgia. Gen. Cuyler was the last survivor of his family of three 
brothers and seven sisters. 

Surgeon Cuyler's classical education was received at Athens Col- 
lege, in Georgia, and he studied surgery and medicine in Charleston, 
South Carolina. At the age of twenty-four he was commissioned in 
the army — April ist, 1834.— an assistant surgeon, and continued 
nearly half a century in the active service of the Medical Department. 

Cuyler's early military life was passed at Southern stations, except 



OBITUARIES. 175 

while he was engaged in the Creek War (1836), the Seminole War 
(i839-*4o), and the Mexican War (i846-'48). During the latter he 
became a great favorite with the army in the field, particularly of 
Gen. Scott, who so esteemed him that, after the war, in a most com- 
plimentary communication, he designated Surgeon Cuyler for Chief 
Medical Officer of the Military Academy and Post of West Point. 
Here, for seven years (i 848-' 5 5), he won golden opinions from every- 
one, and endeared himself alike to soldiers, cadets, officers, and all 
with whom he came in professional or social contact. After his ser- 
vice at West Point he was three years (i855-'58; at Fort Leaven- 
worth, Kan., and the next four (1858-62) at Fort Monroe, Va — two 
of the largest posts in the United States. 

The Civil War had now begun. Cuyler was a Southern man, 
educated in Southern sentiments and principles ; but, painful as it 
was to array himself against his compatriots, his rigid sense of duty 
and his solemn oath of office out-weighed all other considerations ; 
hence, with an elevated patriotism and with punctilious honor, he 
continued faithfully to serve under the revered flag of his country. 

Upon the termination of the Rebellion, Cuyler became the Medical 
Director of the Department of the East and of the Division of the 
Atlantic, in which duties he continued till June 30, 1882, when he was 
retired from active service. 

During his long period of army service he had been promoted a full 
Surgeon February 16, 1847, with the rank of Major ; Medical Inspec- 
tor, June II, 1862, with the rank of Lieut. Colonel of Volunteers;. 
Surgeon, June 26, 1876, with the rank of Colonel in the Regular 
Army; and Brevet Colonel, Nov. 29, 1864, and Brevet Brigadier 
General, U. S. Army, March 13, 1865, for *' Faithful and meritorious 
services during the Rebellion." 

General Cuyler, in 1840, married the only daughter of Judge 
Wayne, of the United States Supreme Court, by whom he had two 
sons, both becoming officers of the army. The youngest, William, 
died many years since, and the eldest, James, who was a Major of 
Engineers and a very promising officer, died a year ago. 

The funeral of Dr. Cuyler took place at Morristown, N. J., on 
Tuesday, April 29th, with Generals Hancock, CuUum, Tower, Fry, 
and Colonels Kendrick, Baylor, McParlin and Janeway, as pall- 
bearers. 



REPORTS OF DISTRICT SOCIETIES. 



ATLANTIC COUNTY. 

To the Chairman of the Standing Committee^ &c. : 

From the portion of the county including Hammon- 
ton, New Germany and Elwood, Dr. Edward North 
reports more than the usual amount of sickness. Last 
summer a severe epidemic of dysentery prevailed, coming 
on frequently without premonitory symptoms ; a profuse 
discharge of blood from the bowels was the first symptom, 
the patient being free from pain, and very greatly pros- 
trated. It responded readily to treatment if taken in 
hand promptly. If, however, it was neglected for a few 
days, the hemorrhage increased, and the patients had a 
long convalescence, requiring a stimulant and tonic treat- 
ment to bring them through. During the winter an 
unusual number of cases of rheumatism and bronchitis 
occurred, and three (3) cases of catarrhal pneumonia are 
reported, all occurring in old people and all resulting 
fatally. Dr. North further reports the absence of typhoid 
fever, a few isolated cases of scarlet fever during the 
winter, and at present a mild epidemic of measles. 

In Atlantic City there is less than the usual amount of 
sickness to report ; Dr. Boardman Reed says that ** dur- 
ing the past year I have found Atlantic City more 
healthful than in any previous year within my exper- 
ience.** He reports that during the early winter occa- 



REPORTS OF DISTRICT SOCIETIES. 1 77 

sional cases of scarlatina were imported from the large 
cities and a very few cases were seen by him among the 
residents. Rotheln or German measles prevailed to some 
extent during the autumn and early winter, and, as Dr. 
Reed goes on to say, ** It is this taken with the few 
scattering cases of genuine scarlatina which occurred that 
led to the sensational reports sent abroad of an epidemic 
of the latter disease.** In my own practice I saw only 
two or three cases of scarlatina, many more of Rotheln ; 
but as health inspector at the time, I saw probably nearly 
all the cases of scarlet fever that occurred in Atlantic City 
during the winter. It is a surprising fact that we escaped 
with so few cases when we remember the great preva- 
lence of the disease in the large cities, and the constant 
arrival of visitors from these places. That we had no 
more is largely due to the prompt and energetic action of 
the Board of Health in carefully quarantining each case 
as it developed, and in insisting upon thorough disin- 
fection after convalescence. 

Dr. Reed has not met with a case of typhoid or remit- 
tent fever during the past year, nor does he know of a case 
of either disease occurring in the practice of any of our 
physicians. A few cases of intermittent fever occurred 
in the persons of visitors from malarial regions, which, as 
Dr. Reed says, ** uniformly yield within a few days to 
very moderate doses of quinine combined with some liver 
stimulant.** 

The Board of Health had to deal with a single case of 
variola during the past summer in the person of a colored 
servant recently arrived from a Southern city. He was 
promptly removed to a hospital provided for such pur- 
poses a few miles from the city, and by thorough disin- 
fection the disease was stamped out, no other case devel- 
oping. 

IS 



178 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Reed reports rather more cases than usual of folli- 
cular tonsillitis, all, however, of a mild type. Not a 
single case of diphtheria has occurred in his practice. Of 
the latter disease, I saw two cases in the early winter, 
both of them imported from Philadelphia and both 
recovering without another person contracting the 
disease. In these cases I found very great benefit to be 
derived from the frequent and thorough local use of lime 
water by means of an atomizer, combined, of course, with 
the free use of stimulants and supporting treatment. 

During the summer the usual large number of children 
suffering with cholera infantum or entero-colitis were 
brought here. I find, however, only seventeen deaths 
recorded as due to these diseases ; certainly a very small 
proportion when we remember that so many are brought 
here only as a last resort. Indeed, so wonderful is the effect 
of our cooling breezes in these affections that if the little 
sufferers have strength to last but for a few hours after 
their arrival, they recover almost without exception. 

Among adults many cases of acute illness occurred 
during the summer months, due to errors in diet and 
mode of life ; these, however, yielded promptly to treat- 
ment. 

Our residents suffer but little from lung troubles. Out 
of the total number of deaths (191) for the last year, 
acute affections of the air passages are stated as the cause 
in only thirteen (13) cases; while phthisis is accredited 
with twenty-four (24) deaths. Of these, certainly not 
over one-half have occurred in residents, the rest being 
persons who have come here when the disease was 
already far advanced. 

It is a source of great pleasure to be able to report 
that no death has occurred among our members during 
the past year. 



REPORTS OF DISTRICT SOCIETIES. 



179 



For the use of physicians who may wish any informa- 
tion as to our climatology, I have been enabled through 
the courtesy of Sergeant Blunden, of the United States 
Signal Corps, to compile the following table showing the 
^range of the thermometer, barometer, mean humidity, 
etc., for the past year. 





Th 

i 


lermometer* 


Moisture. 


Barometer. 




1883. 




• 

§ 

40.6 
52.0 

57. 
55- 
45. 
39-8 

18.7 
II. 

4. 

II. 

8. 

29-5 


• 

c 

56.7 
67.2 

73-0 
70.5 
65.1 
55.6 

45-9 
37-2 

29 2 

37.6 
38.6 

47-0 


• 

U B 

^X 

79-6 
84.4 

78.3 
76.0 

77.5 

78.5 
72.0 

76.8 

75.9 
83.2 

82.0 
75-4 


10 
10 
12 

7 
12 

19 

7 

15 

16 
18 
18 
10 


S CO 

1.78 

3.53 
2.83 

3.21 

5-31 
6.18 

1.25 

2.54 

7.17 

7.44 

5.79 
4.29I 


• 


• 

c 


• 

c 


bo 

c 

0^ 


May 

June 

July 

August. . . 
September 
October . . 
November 
December 

1884. 
January . . 
February . 
March . . . 
April 


79 
84 

94 

91 
80 

75. 
63. 
57. 

50. 

54- 
60. 

67. 


6 

6 
2 


30.364 

30.473 
30.245 

30.249 

30.401 

30.607 

30 . 646 

30.627 

30.819 
30.717 

30.457 
30.194 


29-430 
29.638 

29-731 
29.661 

29-572 

29-432 
29.721 

30.498 

29.177 
29..I75 
29.484 
29.127 


29.958 
29.987 
29.982 
30.028 
30.058 

30.140 
30.152 
30.105 

30.113 
30.057 
30.002 
29.840 


•934 
.835 

.514 
.588 

.829 

1. 175 

-925 
.129 

1.642 
1.542 

-973 
1.067 



Mean temperature for the entire year, 52°. 

Mean summer temperature, 70°. 

Mean winter temperature, 35°. 

Difference between mean summer and mean winter temperature 

35°. 
Total rainfall, 51.32 inches. 

Average per month, 4.28 inches. 



May 14th, 1884. 



J. E. SHEPPARD, Reporter, 



l8o MEDICAL SOCIETY OF NEW JERSEY. 

BERGEN COUNTY. 
To the Chairman of the Standing Committee^ &c. : 

There has been rather less than the usual amount of 
sickness in the county during the year. There is 
always more or less fever of an intermittent or re- 
mittent character prevailing during the summer and 
autumn months, but during the past few years they have 
been less prevalent than formerly, and fevers of a typhoid 
or typho-malarial character are taking their place. This, 
at least, has been the case in my own practice. During 
the past year I have treated a number of cases of genu- 
ine typhoid fever, three of which had severe hemorrhages 
from the bowels, and two of the three died from the 
effect of such hemorrhages. 

[. Less than the usual amount of bowel troubles prevailed, 
and these were of a mild type and yielded readily to the 
usual treatment of such cases. Scarlet fever of a mild 
type prevailed during the months of January, February 
and March, but only a very few cases of diphtheria, and 
these were much milder than during the previous year. 

During December, January and February, I had rather 
more than the average number of cases of pneumonia. 
In all my cases I use aconite in small and frequently- 
repeated doses during the first stage, with hot fomenta- 
tions to the side or chest, and anodynes, if the pain is 
very severe, and small doses of phosphorus, as recom- 
mended by Ringer, in the second stage. This gives me 
better results than any other plan of treatment that I 
have ever tried. When seen in the very first stage of the 
disease, I have frequently been able to abort the attack, 
and prevent it from going beyond the stage of simple 
engorgement of the lung. 

During the present spring I have had quite a number 



REPORTS OF DISTRICT SOCIETIES. l8l 

of cases of inflammatory rheumatism, all of which I have 
treated with aconite and bryonia in small doses, and wine 
of colchicum and carbonate of ammonia, wrapping the 
inflamed joints in cotton and oiled-silk — sometimes bath- 
ing with some soothing embrocation, but more frequently 
not using anything except the cotton and oiled-silk. 

Dr. Demarest, of Areola, says : *^ There has been no 
disease of unusual interest during the past year, except- 
ing one case of spinal meningitis and another of cerebro- 
spinal fever, both resulting fatally — the first after a period 
of eight days, the other after twenty days' illness ; and 
a less amount of malarial and pulmonary troubles than 
usual.'* 

Dr. Ayers, of Fairview, says : ** In the early part of 
the year, no epidemic or prominent disease prevailed. 
Malaria was less prevalent during the entire year than 
heretofore. The summer and fall months were more 
healthy than for many years. During the winter months, 
more than the usual amount of pneumonia and rheuma- 
tism were treated, and during the month of March a 
large number of cases of muscular rheumatism came 
under my care, some of which were very obstinate." 

Dr. Neer, of Park Ridge, says : " I have nothing of 
special interest to report from my locality. We have had 
no epidemics of any kind, but an average amount of 
sickness, general in character and having no peculiarities 
that require special notice.** 

Dr. Reed, of Norwood, reports a few cases of malarial 
and diarrhceal troubles, but not as much of either as in 
previous years. Also two cases of stomatitis complicated 
with glossitis, and one case of puerperal mania, which 
was improving under the use of chloral and veratrum 
viride. 

Dr. Morris, of Norwood, says : *' The past year has 



1 82 MEDICAL SOCIETY OF NEW JERSEY. 

been fairly healthy ; less malarial fever and the cases less 
obstinate. Saw one case of congestive chill that looked 
very unfavorable. On opening a vein, it was with diffi- 
culty that a flow of blood could be obtained. After 
drawing five ounces it flowed freely, and, on taking twelve 
ounces, reaction set in, giving a speedy and good 
recovery, with the^moderate use of quinine.'* 

Dr. Turnure, of Tenafly, says : *' From April to June, 
1883, a mild epidemic of measles prevailed among both 
children and adults. In some of the patients a persistent 
eczematous eruption behind the ears and at the roots of 
the hairs in the temporal region remained for some 
months after recovery. There was about the usual 
amount of malarial trouble. Influenza and follicular 
sore throat were of frequent occurrence from July until 
the present time. A peculiarity of the follicular pharyn- 
gitis was its contagious character when occurring in 
families. The attack was ushered in by a distinct chill, 
temperature loi^ to 103^^, with pain in limbs and muscles 
of back ; the tonsils were red and glazed, with white 
patches covering them. Treated them with aconite and 
belladonna, and astringents locally, with quinine as a 
restorative tonic. During the winter, bronchitis was the 
most noticeable lung trouble. One case of pseudo- 
membranous croup I treated under a tent, in a room with 
a temperature of 80^, with steam from boiling water and 
slacking lime, using yellow sulphate of mercury as an 
emetic when the membrane seemed to encroach upon the 
calibre of the larynx. The child was kept in this atmos- 
phere of steam for ten days, and finally made a good 
recovery. Bronchitis was severe in this case, and was 
relieved by hot poultices and stimulating expectorants. 
The child was given brandy and milk, and one-hatf grain 
of quinine every second hour. Age, six years.'* 



REPORTS OF DISTRICT SOCIETIES. 1 83 

Dr. Currie, of Englewood, reports a few cases of 
genuine diphtheria during the early part of the year. 
They yielded best to injections of dilute solution of 
chloride of sodium up the nares, and large doses of tinc- 
ture of iron — ten to forty drops every half hour or hour, 
according to the age of the patient. Scarlet fever pre- 
vailed to a considerable extent during June, July and 
August, a few cases proving fatal. Through September, 
October, November and December, fevers of an inter- 
mittent, remittent and typho-malarial type existed to an 
alarming extent. A large number ran a course of over 
twenty-four days, five a course of thirty-six days, and one 
case ran a straight course of forty-six days, with a morn- 
ing temperature 102°, and evening 103*^, 104^ and 105°, 
but with an absence of diarrhoea or hemorrhage in all of 
them. The origin of this epidemic was impure water, 
defective plumbing, dampness, and malaria in general. 
Following several of the cases of fever which ran a pro- 
longed course, acute arteritis occurred, especially when 
the patient undertook to walk soon after convalescence. 
I have encountered this affection before, and think the 
reason it affects the lower extremities oftenest is because 
of their being used before they are sufficiently strong to 
bear the weight of the body. The arteries most fre- 
quently affected were the femoral, popliteal and tibial. 
In one case the femoral artery seemed to be entirely 
obliterated. The pain was severe along the course of 
the vessel, and a feeling as if a cord were under the 
finger. An epidemic of catarrhal fever existed through 
June and disappeared in July. It came on suddenly ; 
often with a chill and pain in the throat and throughout 
the body, with a temperature from 100^ to 102^, with 
lassitude and restless nights ; eyes injected and watery, 
with slight nasal catarrh, cough and clammy skin ; kid- 



1 84 MEDICAL SOCIETY OF NEW JERSEY. 

neys and bowels inactive. It ran a course of from one to 
two weeks. 

** During the past year I have succeeded in aborting 
three cases of bubo with sulphide of colchicum, given in 
one-grain doses every fourth hour. I consider it a relia- 
ble remedy if given thirty-six hours before suppuration 
has commenced. These cases were all colored men, and 

old sinners at that." 

J. M. SIMPSON, Reporter. 

SCHRAALENBURGH, May 15th, 1 884. 



Two interesting papers accompany the report from Bergen County 
— one on " The Artificial Alimentation of Infants," by Milton Tur- 
nure, M. D., of Tenafly ; the other by Frederick Morris, M. D., of 
Closter, on " Bloodletting." The following are abstracts of same : 

The Artificial Alimentation of Infants. 

BY MILTON TURNURE, M. D., OF TENAFLY. 

In the first, Dr. Tumure speaks of the prevalence of infantile sum- 
mer diseases in our towns and cities ; of the large number of young 
children who have to be fed on artificial foods of some variety ; of 
improper food being the cause of a very large proportion of the cases 
of diarrhoea, cholera infantum, etc ; and of the importance of the 
physician, in giving advice as to diet, being led by a knowledge of the 
laws of physiology and organic chemistry, rather than allow himself to 
be deceived by the advertisements of the concoct ors of the innumerable 
artificial foods in our medical and other journals. He believes cow's 
milk of good quality, mixed with a proper equivalent of water and de- 
prived of half of its fat, offers the safest and most rational substitute for 
the mother's milk ; that when it does not agree with the child it is owing 
either to the impurity of the milk or to the large amount of fat which 
it contains. The majority of the artificial foods advertised contain 
considerable starch or gluten, and he believes that such are more 
harmful than beneficial. He has observed in winter, as in the sum- 
mer months, bad results in many cases from the use of those foods. 



REPORTS OF DISTRICT SOCIETIES. 185 

In some cases of indigestion, etc., he had found barley water alone to 
agree best. He thinks it a matter of great importance to give the 
child frequently through the day, in warm weather, a small quantity 
of water to drink. 



Bloodletting. 

BY FREDERICK MORRIS, M. D., OF CLOSTER. 

Dr. Morris, in his paper on "Bloodletting," cites the following 
cases : 

" G. B., a man 54 years of age, October 25th fell with what was 
called ' a stroke,'— no doubt apoplectic. I was called to see him. 
Found his right side paralyzed. He had lost the power of articula- 
tion, and senses are much impaired. Pulse slow and feeble. He had 
been * a hard drinker * for many years. Even in my earlier days, 
when bleeding in such cases was the rule of practice, one would 
hesitate in the case of a steady drinker. But I saw no other hope for 
him, and opened a vein. I was glad to perceive that as the blood 
flowed the pulse rose. I took sixteen ounces. Gave a cathartic and 
applied counter-irritants. He improved. On November 2d cupped 
the nape of the neck to four ounces. He is now in possession of his 
usual faculties of motion, speech and capacity for business ; and, 
having the fear of death by palsy before his eyes, he is a practical 
teetotaler." 

" On the 1 8th of the present month, Miss G., a maiden lady, tem- 
perate, but of a very full habit, 52 years old, usually in robust health, 
was seized, on arriving at our depot from New York, with numbness 
and powerlessness of her left side, able neither to raise her left arm, 
hold anything in her left hand, or move her left leg. The symptoms 
increased, as did a feeling of distress about her head. 

" On seeing her on the 21st, I found her face flushed ; neck turgid ; 
pulse small, not rapid, but with a feeling of hardness on pressure ; the 
skin and extremities cool. She declined being bled from the arm for 
fear. On cupping the nape of the neck the blood flowed freely, and 
eight ounces were drawn with an immediate sense of relief. Gave 
her a physic, and to-day {22dj the power of her lower extremity is 
almost normal. She can raise her arm, but not yet take hold. I 
believe that without that speedy relief to the circulation, which could 



1 86 MEDICAL SOCIETY OF NEW JERSEY. 

not be g^ven effectually any other way, she would probably have had 
an attack of fatal apoplexy." 

The Doctor closes his paper with an earnest appeal to the profes- 
sion not to discard this " effective remedy which, for ages, held the 
confidence of the people and of their physicians. * * * 
A judicious and timely bloodletting is a safe and efficient aid in the 
relief of many disorders of the system, and for which there is no 
substitute,** 



BURLINGTON COUNTY. 

7!:? the Chairman of the Standing Committee^ &c, : 

During the year there has been comparatively little 
sickness. During May and June, intermittent fever, 
parotitis and rubeola of the ordinary grade and custom- 
ary type were the principal diseases. In July and 
August, cholera infantum, cholera morbus and diarrhoea. 
A few cases of the first-named disease were speedily 
fatal. Improper alimentation was a frequent cause of 
trouble among children. September produced a case of 
variola confluens. On the tenth day the disease was at 
its height; pulse 120, temperature 104*^. His face was 
kept well dusted with oxide of zinc ; elsewhere, he was 
anointed with a five per cent, carbolized oil. Many of 
the pustules evinced a malignant form of the disease. 
The treatment was anodyne, supporting and, for a time, 
slightly stimulating. Several vaccinated members of the 
family subsequently had the disease in a very mild form. 
At the present time, May, 1884, his face shows but slight 
evidence of the eruption. He was vaccinated when an 
infant — twenty-five years ago. I found it so difficult to 
produce vaccinia among children that I abandoned the 
operation. 



REPORTS OF DISTRICT SOCIETIES. 1 87 

Drs. Gauntt, Hall, Lansing, Parrish and Pugh, of Bur- 
lington, report cases of parotitis, pertussis, rubeola and 
scarlatina. Dr. Pugh states that there was an endemic 
of mumps and many cases of scarlatina. He believes 
that the malignancy of scarlet fever depends more upon 
the constitution — the idiosyncrasy of the individual — 
than upon the materium morbi. The clothing may be a 
cause of infection. Dr. Lansing reports some malarial 
and typho-malarial cases ; Dr. Gauntt, many cases of 
mumps, and one case of typhoid fever from drinking foul 
water. Dr. Taylor, of Beverly, reports scarlatina in his 
practice. The cause was supposed to be sewer gas. Drs. 
Jemison, Shipps and Young, of Bordentown, that the 
unusually good health of the year was varied with a few 
cases of mumps, scarlatina and diphtheria, but not one 
case of typhoid fever. Drs. Chamberlain, Barrington, 
Melcher and Parsons, of Mount Holly, mumps, rubeola 
and malignant diphtheria, caused by bad drainage. 
Some of these were followed by palsy of the throat. 
Dr. Hollingshead, of Pemberton, states that by way of 
an offset to the remarkable health, there were a few cases 
of mumps. Dr. Van Mater, a few cases of mumps in 
and around Columbus. In October and November a few 
cases of diphtheria appeared. The early symptoms of 
membranous croup are often very obscure, and it is diffi- 
cult to tell what will be the condition of the patient on 
the following day. I except diphtheritic croup, recovery 
from which I never saw. The exceedingly unfavorable 
prognosis of this disease, and the inability to obtain 
efficient nursing, prohibits the operation of tracheotomy. 

On October 226. a mother brought her three-year-old 
daughter several miles ** to be relieved of something in 
her throat,'* which she said caused difficult breathing at 
night and retching, at the same time. The croupy cough. 



l88 MEDICAL SOCIETY OF NEW JERSEY. 

and the diphtheritic exudation were absent. 23d. I did 
not see her. 24th. No membranous exudation visible. 
A suffocative cough and sonorous rhonchi in both lungs 
were the principal symptoms. She had not yet kept to 
her bed, but walked about the house as usual. 25th. She 
was moribund ; breath offensive ; tonsils covered with 
the diphtheritic exudation ; pulse, 200 ; breathing, 60 ; 
lungs congested. Where the exudation began I cannot 
tell. I believe it extended upward into the pharynx and 
downward into the bronchi. Not until the 25th was 
there evidence of constitutional poisoning, or that she 
would die of laryngeal stenosis. The tincture of the 
chloride of iron, the chlorate of potassium, quinia, alcohol 
and good alimentation were the main factors in the treat- 
ment. If I were obliged to choose one only of these 
medicines, I would select the alcohol. I have tried this 
with niilk, without other medicine locally or generally, 
and believe it as efficient as many other highly-recom- 
mended agents. 

Albuminuria is by no means an infrequent disease. It 
is a question whether it should always be called Bright's 
disease. In many cases an autopsy alone must establish 
the diagnosis. Squibb says that '" small proportions of 
albumen in urine, as shown by the more delicate tests, 
have, when taken alone, little or no pathological signifi- 
cance." Flint : " The small granular kidneys sometimes 
secrete urine which in no way differs from the normal." 
Professor Semmola considers the lesions of the kidneys a 
secondary affection — that an abnormal quantity of albu- 
men in the blood produces congestion of the kidneys and 
chronic paranchymatous nephritis. Medical men must 
here reason a posteriori, not a priori. With the assistance 
of the books and of experience, the diagnosis must be an 
individual judgment, based on a few objective symptoms 
in many cases. 



REPORTS OF DISTRICT SOCIETIES. 1 89 

Cases of typhoid fever were rare. The fevers occurring 
were generally of the intermittent, remittent or continued 
forms. The typical temperature, eruption and diarrhoea 
of typhoid fever were conspicuous by their absence. 
Intermittent fever, in the great majority of cases, dropped 
the first stage. It very often happens that persons who 
have not for many years, if ever, had the intermittent 
fever, become subjects of the disease after getting wet in 
a rainstorm. 

March 24th, 1884, I saw a case of malignant intermit- 
tent fever or congestive fever — the only one I remember 
within twenty-five years. Mrs. S., married, age 31 years. 
Last autumn she had the intermittent fever. I saw her 
for the first time March 20th, at four o'clock P. M. I 
was informed that at 11 A. M. on the preceding day she 
had had a chill. On the morning of the 20th she 
attended to her accustomed duties, and considered her- 
self well. At 1 1 A. M. the fever, without a chill, returned. 
I found her sweating profusely; pulse, 120; resttess ; 
skin hot, and complaining of headache. Half an hour 
afterwards she became comatose, and died on the 22d of 
congestion of the brain. If an intermission, or even a 
remission, had occurred, what a good subject she would 
have been for the subcutaneous injection of the hydro- 
bromate of quinia, which is soluble, in the proportion of 
four grains to the twenty minims. 

Another unusual cause of death in this neighborhood 
is gangrene. A butcher of this place, aged 65 years, 
weight 240 pounds, temperate in everything but eating, 
complained when I saw him, April 9th, 1883, of pain in 
the right great-toe ; heart's action feeble and irregular ; 
the sounds muffled ; no anasarca ; urine 1,026, contained 
albumen and sugar ; could not detect arterial pulsation in 
the leg ; for several weeks, none in the popliteal ; after- 



igO MEDICAL SOCIETY OF NEW JERSEY. 

wards it returned. Atrocious pains, sloughing of the 
parts and death all occurred within four months. So far^ 
I believe no satisfactory explanation has been given for 
the saccharine urine in senile gangrene, or the small ulcer 
which spreads phagedenically indicative of diabetic gan- 
grene. As the connection between gangrene and diabetes 
has been known only within the last twenty years, the 
general and local causes have not received the attention 
they deserve. 

S. C. THORNTON, Reporter. 

Burlington, May 12th. 1884. 



Muscular Hypertrophy of the Stomach. 

BY DR. ALEX. MARCY JR., OF RIVERTON. 

The following case illustrates very beautifully that rare pathological 
condition — muscular hypertrophy of the stomach : 

Wm. G., American, aet. 46, came under my care Sept. 15th, iSSr. 
His condition was rather a peculiar one. He was greatly emaciated. 
extremely jaundiced, and very weak. There was total anorexia, and 
it was impossible for him to take over two tablespoonfuls of any fluid 
at one time. Had constant diarrhoea ; stools of a light clay coior, not 
Offensive ; tongue enlarged, smooth and bright red ; he suffered no 
pain ; there was no elevation of temperature ; heart and lungs were 
normal ; liver slightly enlarged, but '^o tenderness over it. or enlarge- 
ment of the gall bladder ; stomach appeared somewhat contracted 
and siigiuly dull on percussion ; no tumor could be detected. He 
was supposed to be suifering from ;aundice, from suppression of the 
secretions of bile. The :hird day after coming under observation he 
was taken wiin a chill, which was roilowed by fever: complained of 
pain in siae ; !iac siig'U cough, difncult and rapid breathing, and in a 
few hours died. 

His previous history, as afterwards obtained from the physician 
who had attended him at intervals, was as follows : At the age of 18 
vears he eniisteil in the army, and waile there suffered from chronic 
diarrhuea. For years oiterwaru ne .vas a free drinker. During the 



REPORTS OF DISTRICT SOCIETIES. I9I 

last five years of his life he had had, at intervals, attacks of vomiting, 
frequently accompanied by diarrhoea and jaundice. The ejected mat- 
ter was either greenish or white, and the stools were usually copious, 
green and fluid. 

At the autopsy, all the organs appeared to be healthy excepting the 
lungs and the stomach and duodenum. The left lung was in the first 
stage of pneumonia, and this disease had probably been the immedi- 
ate cause of death. The condition of the stomach was exceedingly 
interesting. It had undergone remarkable contractions, measuring in 
length only 12.5 cm., and in diameter but 3.75 cm. at the pyloric, and 
4.35 cm. at the cardiac extremity. The lumen was greatly diminished, 
and the organ could not have held over 60 c.cl. of fluid. The little 
finger pushed into the interior encountered a stenosis at about the 
centre of the organ, which it could scarcely pass. 

On opening the stomach it was seen that this was produced by a 
narrow, fibrous band, on either side of which was a stellate cicatrix. 
At the pyloric extremity the lumen was almost obliterated, and would 
scarcely have admitted a goose quill. The mucous membrane was 
abnormally smooth, and the stomach wall everywhere very much 
increased in thickness, measuring toward the pyloris 1.5 cm., and at 
the greater curvature i cm. This same thickening and narrowing 
had extended into the duodenum until it involved also the ductus 
communis choledochus, which it completely occluded. Beyond 
this, the intestine rapidly assumed its normal dimensions. 

Under the microscope the following histological conditions were 
revealed : The mucous membrane is very little altered, and in thick- 
ness is about normal. A slight growth of newly-formed connective 
tissue is to be found among the glands. In the muscularis mucosas 
there has been a great increase in the amount of muscular fibre, 
which is mingled, however, with many bundles of connective tissue. 
The increase of thickness in this coat is seven or eight-fold, due 
almost entirely to the overgrowth of the muscular element. The 
muscular element of the stomach is increased about three times in 
thickness. Here, too, this increase is due to an hypertrophy of the 
muscular tissue, although in many places there exists an intimate 
mingling with it of newly-formed connective tissue. The fibrous 
tissue dissepiments are slightly increased in thickness. The serous 
layer is unaltered. 

The sub-mucous layer has undergone the most peculiar change. 



192 MEDICAL SOCIETY OF NEW JERSEY. 

In this there is not only found an irregular deposit of this same newly- 
formed imperfectly-fibrillated connective tissue, such as is found 
elsewhere in the organ, but also a new growth of smooth^ muscular 
fibre. This fibre is scattered in larger or smaller bundles throughout 
the sub-mucous layer, in some places exceeding the connective tissue 
in amount ; in others, falling short of it. Towards both the muscular 
wall and the muscularis mucosae is the greater amount of muscular 
fibre, indicating, perhaps, that in its growth it has extended from 
these two tunics. The thickness of this tunic is greatly increased, 
but to exactly what extent cannot be determined, owing to the 
gradual blending of this with the two contiguous tunics, produced by 
the depositions of newly-formed muscular fibre in it. The lumen 
of the bloodvessels of the sub-mucosa, and the thickness of their 
walls, are greater than in the normal stomach. 



CAMDEN COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

Dr. Godfrey, of the City of Camden, reports that dur- 
ing the spring months of 1883 there was the usual num- 
ber of inflammatory affections, concerning which there is 
nothing to be added in the way of treatment. He men- 
tions a case of true croup, in which advantage was 
derived from building a blanket-tent around the crib of 
the child and keeping the atmosphere within the tent 
continually moist with steam during the progress of the 
disease. Stridulous breathing was considerably allayed 

by the steam, and it materially contributed to the 

» 

recovery of the child. In cases of croup, in which it is 
difficult to effect emesis, it is well to resort to hypodermic 
injections of apomorphia. 

During the summer months there were but few cases of 
cholera infantum in the city. This was due to an unusu- 
ally cool summer. There are cases of diarrhoea occurring 



REPORTS OF DISTRICT SOCIETIES. I93 

in children during the summer months which are improp- 
erly called cholera infantum. In the absence of a copious 
watery flux, attended with vomiting and' emaciation, the 
term cholera infantum is a misnomer. 

The number of cases of typhoid fever has not been as 
great as during the previous twelve months, notwith- 
standing the character of the Delaware water remains the 
same. This is due to the extension of the culvert system, 
to the cleansing of the water basin, and the unusual 
coolness of the summer. 

Malarial fevers have been present throughout the year. 
It is not strange that malarial poisoning is prevalent ; for 
our city, being situated for more than four miles upon 
the unimproved banks of the Delaware, is at the mercy 
of effluvia arising from the organic decomposition in its 
mud-banks. Fresh-water marsh lands, containing a high 
percentage of organic matter as well as the alluvial 
deposits of the Delaware, breed malaria. The growing 
vegetation of marshes has nothing to do with its develop- 
ment. The soil surrounding us is malarious. Though 
highly cultivated, it has imbedded in it the products of 
vegetable decay ; and having a sub-soil of marl or clay, 
which prevents thorough drainage, it is kept more or less 
moist, and, during the continuous heat of summer, 
generates malarial germs. I say malarial germs, for the 
doctrine of the gaseous exhalations of vegetable decom- 
position, as the causative agents of the disease, has been 
abandoned. 

During the winter and spring, acute inflammatory dis- 
eases prevailed. Scarlet fever and diphtheria have been 
less common than usual. The only ailments which have 
approached the character of an epidemic are whooping- 
cough and jaundice, the latter being more a manifestation 
of malaria than of an idiopathic condition of the liver. 

13 



194 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Mecray, of Camden, states that in his practice the 
summer months were characterized by unusual health. 
During the succeeding fall months, intermittent and 
remittent fevers prevailed more extensively than usual. 
In the winter, pertussis, rubeola, bronchitis, pneumonia, 
tonsillitis and rheumatism were met with every day, while 
scarlet fever and diphtheria were frequently seen but did 
not become epidemic, and there was no fatality accom- 
panying them. 

Typhoid fever has also prevailed, but to a much smaller 
extent than during the previous twelve months, the dis- 
ease running its course mildly and with few complications. 

Dr. Benjamin has met with the usual diseases during 
the past year in the City of Camden. The summer was 
more healthy than the one before it, but the winter of 
1883 and 1884 was less so than the one which preceded 
it. Bovyel diseases, especially diarrhoea and irritability of 
the alimentary tract, were marked. During the past few 
months a remarkable phenomenon has occurred in the 
form of epidemic jaundice, of undoubted malarial origin. 
While plain intermittent and remittent fevers have not 
been so common, malarial poisoning has presented itself 
in Protean forms. The usual contagious diseases have 
prevailed in a mild form. Dr. B. thinks most of the dis- 
eases we have could be avoided if the people would study 
hygiene. 

Dr. Hamilton, of Camden, reports malarial diseases in 
their varied types and phases, and numerous cases of 
laryngitis, bronchitis, etc. 

Dr. Palm reports the total number of patients treated 
at the Camden City Dispensary during the year ending 
April 30th, 1884, was 955, of which number fully two- 
thirds were reported as being due to malarial influences 
and ordinary colds. The remaining third of the cases 



REPORTS OF DISTRICT SOCIETIES. I95 

was composed of the diseases which usually occur among 
the classes which patronize a charitable institution. 

There were a few cases of scarlet fever and seven cases 
of typhoid fever. There were eight cases of variola and 
varioloid reported, of which three terminated fatally. 

During the year there were 875 deaths in the City of 
Camden, the greatest mortality occurring in January, 
1884, when the number was 100. The lowest number of 
deaths, 44, occurred in May, 1883. 

The following is an enumeration of the principal causes 
of death: phthisis pulmonalis, 135 ; diseases of brain, 88 ; 
diseases of heart, 55 ; cholera infantum, 41 ; pneumonia, 
40 ; typhoid fever, 30 ; scarlet fever, 24 ; diphtheria, 25. 

From Haddonfield, Dr. Jennings reports the usual run 
of diseases, with an abundance of those affections induced 
by malarial influences, which always obtain pre-eminence 
in that place. The Doctor says all diseases are modified 
by the malarial poison, so that quinine cures everything. 
There has been no typhoid fever and no epidemics of any 
kind. 

Dr. Tomlinson, of Gloucester City, reports typho- 
malarial and intermittent fevers. Scarlatina anginosa 
and pertussis have prevailed as epidemics. 

Dr. Branin, of Blackwoodtown, says the first six months 
of the year just passed have been unusually healthy and 
free from epidemic diseases, the rate of mortality being 
lower than it has been for several years, during the same 
season. In May, June, September and October, they had 
some isolated cases of scarlet fever of a mild form, with 
one malignant case, which died on the fourth day. In 
September and October, occasional cases of diphtheria 
occurred ; quite severe, but no deaths. During June, 
July and August, the usual summer complaints of child- 
ren prevailed to a certain extent, but they were not 



196 MEDICAL SOgiETY OF NEW JERSEY. 

severe and yielded readily to treatment. Dr. B. says : 
** We have had intermittent fever in each and every 
month, but less than one-half what we had in the several 
previous years, and less quinine was required to cure it. 
Remittent fever prevailed during July, August and 
September. Typhoid fever began about the last of 
August, since which time there have been several cases 
but no deaths. Cholera morbus and dysentery were very 
rare during the summer months.** Dr. Branin reports 
several cases of pneumonia in September, which is very 
rare at that season, in his practice. An epidemic of 
rubeola commenced about the first of the year, and has 
continued to the present time. There was the usual 
trouble with the air passages ; in some instances very 
severe, but no fatal cases. 

There were two cases of typhus fever taken to the 
alms-house at Blackwoodtown. The first, an Irishman, 
was brought from near Pea-shore. He came up the river 
on some vessel, and was taken off there and eventually 
sent to the alms-house. The other was a German who 
had been sleeping in Castle Garden, New York City, for 
several nights, then tramped across the State, and was 
picked up in Delaware township and sent to the alms- 
house. Both cases recovered — one in six and the other 
in four weeks. The rigid system of isolation prevented 
the spread of the disease. 

In the towns of Waterford and Winslow and vicinity, 
during the first half of the Society's year, there was less 
than the usual amount of disease, with the customary 
exemption from malarial fevers, excepting that in the lat- 
ter place and vicinity epidemic dysentery of a grave form 
prevailed during the summer months. This disease has 
prevailed in Winslow on several previous occasions, and 
is undoubtedly due to defective sanitary arrangements. 



REPORTS OF DISTRICT SOCIETIES. I97 

During the winter and spring, owing to the unusual and 
almost continuous cloudy and damp weather, rheumatism 
— chiefly of the sub-acute form — pharyngitis, laryngitis, 
tracheitis and bronchitis were very prevalent, hardly a 
family escaping. Some of the cases of bronchitis were 
very stubborn. Not a single case of pneumonia pre- 
sented in this section of the county. Recently, rubeola 
has been endemic in Winslow, the majority of the cases 
being of a mild form. 

JNO. W. SNOWDEN, Reporter, 



A Case of Pleurisy Resulting in Pyothorax. 

BY A. M. MECRAY, M. D., OF CAMDEN. 

May 21, 1883, was called to see D. S., aged 6J years. May 20th, 
1883, had been suffering from hoarseness, accompanied by slight 
fever and cough. Previous to my seeing her she had a decided chill, 
with fever following; vomiting; intense pain on left side, at the pleural 
covering of the diaphragm ; short, dry cough ; breathing considerably 
embarrassed, with dyspnoea rapidly increasing. I diagnosed dia- 
phragmatic pleurisy. 

The fever was considerable during the first twelve hours, attended 
with all the characteristic phenomena of this form of disease : skin 
hot, tongue furred, urine scanty, pulse contracted, and the respiratory 
murmur diminished. 

On the following morning I found an effusion sufficiently large to en- 
tirely obliterate all healthy resonance. Upon percussion, the dullness 
amounted to perfect flatness. Total obliteration of the respiratory 
Biurmur, very little pain, with moderation of fever, great dyspnoea, 
and the patient unable to lie upon the sound side. My attention and 
efforts were now directed towards the absorption of this liquid. A 
\rge was ordered, to be followed by saline cathartics, with 
diaphoretics. lod. of potassa, counter irritation, etc., 
^ until the twelfth day after the effusion, when a chill' 



198 MEDICAL SOCIETY OF NEW JERSEY. 

followed by hectic form of fever, led me to suppose that the liquid 
had become purulent, and that surgical interference was demanded. 
The left side was found, by measurement, considerably larger than 
the other ; the heart was pushed over, so as to be distinctly felt, beat- 
ing under the nipple of the right side ; all respiratory murmur 
abolished, and vocal thrill wanting. I advised immediate aspiration, 
and suggested a consultation with Prof. Wm. Pepper, of Philadelphia, 
which was held June 3d, 1883, when aspiration was performed, 
resulting in the discharge of twenty-two ounces of thick pus, fol- 
lowed by immediate and marked relief. 

Four days subsequently, it was decided to introduce a drainage 
tube, which was accordingly done, by using an ordinary canula and 
trocar, paitly emptying the chest of the pus, and passing a Jacques 
catheter through the canula, allowing about three inches to remain in 
the cavity of the chest ; the canula being withdrawn, the pus gently 
oozed away into a mass of oakum, \Wth which the side was kept 
covered. 

The operation was performed between the seventh and eighth ribs, 
in the axillary line ; local anaesthesia — ice and salt was applied to the 
skin until it was frozen. The tube was held in position by passing a 
strand of silk through the tube and around the body, with adhesive 
plaster over the silk. 

The discharge gradually dimished, and two weeks after the intro- 
duction of the tube, it was thought that the fistulous opening could 
be kept so by the daily introduction of a solid catheter. When the 
tube was removed, much to my disappointment, no pus discharged, 
and the pain of introducing the catheter was so very great that I was 
again obliged to use the drainage tube. The pus now was very 
offensive ; the stomach sickened, the fever increased, and for more 
than a week death seemed inevitable. No injections of antiseptic 
solutions could be Ubeii, alihouc;h the indications demanded it. Con- 
st iiiUional treatn^ent was all that could be givep, champagne being 
the onl) thing the stomach would retain for some days. The patient 
j>racUjall\ rallioil, ,\n{\ on the tilth day of July was removed to Asbury 
Park, N, I„ and placed under the care of Dr. Henry Mitchell, whose 
pioft*N>ioi^\l care and ability added largely to the rapid recovery made. 

On the -\^th da\ of Juh. t^Sv ei^^ht weeks after the introduction of 
the diaina|>t* tube, it wasiemoved, the oriiice being kept open by a 
M^hd cail^etei pa^Jsed twice daily, uniil August 1st, when all discharge 



REPORTS OF DISTRICT SOCIETIES. I99 

had ceased, and it was then allowed to close. The patient, at this 
date, has entirely recovered ; the chest walls, which were sunken, have 
filled out to nearly their normal condition ; the spine, which was 
curved, now being straight and natural. 



HOMCEOPATHIC REMEDIES. 
BY JNO. R. STEVENSON. 

Among the fungi that have sprung up with the civilization of the 
nineteenth century, there is no one more remarkable than homoeopathy. 
Ninety years have not yet elapsed since its founder announced to the 
world that he had discovered a new law in medicine ; yet within that 
time the new creed has spread throughout the civilized world, has 
built colleges, endowed hospitals, entered State universities, and 
claims its patrons among the learned, the wise and the affluent. 

A clear understanding of homoeopathic remedies cannot be had with- 
out a knowledge of what homoeopathy is. A short sketch of it will, 
therefore, preface this paper. 

About the year 1796, Samuel Hahneman, a German physician, 
educated, visionary, dogmatic, but of indefatigable industry, declared 
that he had discovered a new law in medicine, to which he gave the 
Latin title " similia similihus curanttir " — likes cure likes ; * that 
is, any substance which, taken into the healthy human body, 
especially in excessive doses, produced certain symptoms ; and it 
would, when administered in a properly-diminished dose, cure any 
disease that presented similar symptoms. This so-called law is the 
corner-stone upon which has been built the whole superstructure of 
homoeopathy. Dogmatically proclaimed by Hahneman, it has been 
held by its followers to be as true as the law of gravitation. No 
doubt of its authenticity is to be entertained. To question or dispute 
it is to be not a homoeopath ; destroy it or acknowledge it to be 
untrue, and homoeopathy falls to the ground. That this is still their 
doctrine at the present time, may be seen from the following para- 
graph, taken from a homoeopathic journal of 1882, which claims to 
quote the saying of one of their greatest leaders, Dr. Carroll Dunham, 
and which says : " The great law— ^/w///^ similibus cura7ttur — 
teaches us to select a remedy, the characteristic pathogenetic symp- 



2CX) MEDICAL SOCIETY OF NEW JERSEY. 

toms of which are very similar to those of the patient. This grand 
generalization is supported by a multitude of facts. We accept it. 
It takes no heed of the names of diseases, nor of pathological theo- 
ries of the seat and origin of diseases. It requires that the symptoms 
shall be collected and compared with the materia medica every time 
a prescription is made, and that the drug that has produced symptoms 
most similar to those of the patient shall be chosen and given." 
" This," adds the editor, *' is a true homoeopathic prescription." 

Homoeopaths do not claim to have discovered anything new in 
chemistry, anatomy, surgery or obstetrics, or to differ in their views 
of them from those of our own profession. They acknowledge that, 
until recent years, all the knowledge they possessed of them was 
derived from general medical and scientific literature. The only 
works on surgery published by them in the English language is a 
minor surgery, and a manual of surgery by Gilchrist, and a system of 
surgery by Dr. W. F. Helmuth, of New York. In obstetrics there is 
but ai single volume issued — " Obstetrics and the Diseases of Women 
and Children, by Dr. H. N. Guernsey, of Philadelphia," in 1869. 
Anatomy seems to be entirely ignored, as on this branch there is no 
publication of any kind. In physiology they accept the teachings of 
the prominent physiologists of the day, except on such points as 
militate against their law of similars. It is only in therapeutics, 
materia medica and practice that they claim to be original. How far 
they haye progressed in therapeutics may be surmised from the fol- 
lowing article, in a late number of the Homoeopathic Medical Record, 
by Dr. J. C. Peters. He says : " All the great modern advances in 
therapeutics have been made in the regular school, which must be 
regarded as the newest, most progressive and by far the most scien- 
tific one. Homoeopathy has made no advances in its own direction 
during the last twenty-five years, and must be regarded as an old, 
almost effete and dying system, which would long ago have ceased to 
exist, if its adherents had not adopted so much from the regular 

school." 

Again, in a report made in 1882 by a committee of the "Central 
New York Homoeopathic Medical Society," appointed to take into 
consideration the proffer of the New York Medical Society to consult 
with all legal praclii loners, they state, among other matters, that 
'* your committee find that the sole difference between the old school 
and homoeopathy is in the administration of drugs for the cure of the 



REPORTS OF DISTRICT SOCIETIES. 20I 

sick." It is therefore evident that in examining homoeopathic reme- 
dies — the materia medica and application of which are indissolubly 
connected — we shall be investigating the very essence of homoe- 
opathy. 

. Any substance may be used as a remedy if it has been piroved to 
be homceopathic to a disease. The list of symptoms or effects 
belonging to each drug is called the proving of the medicine. To 
ascertain this, the drug is taken without any foreign substance mixed 
with it, and is administered to a perfectly healthy person — usually the 
prover himself, and as many of his friends as he can induce to join 
him in the experiment. The symptoms that follow are then carefully 
noted. This then becomes a homoeopathic remedy for any disease 
that shows similar symptoms. For the poisons, they accept as correct 
the effects detailed in the standard works on toxicology — such as 
Taylor's — together with such as may have fallen under the notice of 
their own observers in cases of poisoning. These provings cover a 
great number of articles, and their literature is filled with the results 
thereof and the discussions thereon. They do not make any chemical 
or physiological examination of the proximate principles of medicines ; 
neither is it deemed necessary to do so. The leading homoeopatt^s 
are agreed that Hahneman never expressed any wish that his disciples 
should acquire any other knowledge of drugs than to know the symp- 
toms produced by them ; nor do his followers at the present day 
claim any necessity for further knowledge, except the advantages of 
general culture, and that the practitioner may go forth for his work 
without the cumbersome apparatus of books of reference. 

There are three homoeopathic pharmacopoeias : Dr. Schwabe's 
" Pharmacopoeia Homoeopathica Polyglotta " is the accepted authority 
in Germany. Boericke and Tafel's " American Homceopathic Phar- 
macopoeia " holds the same position in the United States, although 
both are issued by a private person or firm. The British Homoeo- 
pathic Society has authoritatively published (1882) the " British 
Homoeopathic Pharmacopoeia " as the standard for Great Britain. 
The two former contain very similar directions for the preparation of 
their remedies, and differ in some minor methods from the latter ; but 
as this has official sanction, its manipulations are the ones that will be 
described in this paper. 

On examining these books, the first thing that strikes the attention 
is the difference in nomenclature between them and the U. S. Phar- 



202 MEDICAL SOCIETY OF NEW JERSEY. 

macopoeia. Cinchona is called china, sulphate of quinine is chininum 
sulphuricunn, chalk is calcarca, sodium is natrum, potassium is kalium, 
and mercury is mercurious. These, and others differing from ours, 
are the Latin names which were in use in Germany in Hahneman's 
time ; and some of them are to-day officinal in the pharmacopoeia of 
the German Empire. At the present time, a discussion is going on as 
to the propriety of changing these names, so as to conform to modern 
chemical and medical nomenclature. 

Homoeopathic remedies are prepared from vegetable substances by 
expressing the juice and mixing it with alcohol, in which the expressed 
plant has been steeped for some hours. In those that contain but 
little juice, or where they cannot be obtained fresh, the virtue is 
extracted from the dried article by percolation with alcohol. In each 
case the resulting tincture is made so as to contain the medicinal sub- 
stance in the proportion of one to ten. These are the mother tinc- 
tures. Where they are made from dried plants, their strength is that 
of the majority of the tinctures in the U. S. Pharmacopoeia of 1880; 
the only difference is, that in the latter some are made with alcohol 
and some with dilute alcohol. These mother tinctures are repre- 
sented in scrip and in print by Greek letters ; and from these are 
made what are variously named dilutions, attenuations or potencies. 
The first dilution is made by mixing one part of the mother tincture 
with nine of alcohol ; the second, by adding one part of the first to 
nine of alcohol, and so on up to the sixth. These are made on the 
decimal scale, and to represent them an X is added to the numeral 
thus: iX, 2X, 3X — first decimal, second decimal, third decimal. 
The second, fourth and sixth decimals will therefore correspond with 
first, second and third of a centesimal scale, in which the dilutions 
are prepared in the proportion of one to ninety-nine, and are marked 
I, 2, 3, &c. The latter is the method originally used, and by many is 
preferred to the former. The dilutions of the mineral acids and 
soluble mineral substances are made with water. The metals and 
their insoluble salts are prepared by trituration. A grain of the sub- 
stance is rubbed up with nine grains of sugar of milk to make the 
first trituration, a grain of this with nine grains more of sugar of 
milk for the second, and so on to the sixth. After the sixth decimal, 
the attenuation is commonly carried on by solution. A grain of the 
sixth trituration (third centesimal) is mixed with fifty drops of water, 
to which is added fifty drops of alcohol. A drop of this — the fourth 



REPORTS OF DISTRICT SOCIETIES. 203 

dilution — is added to ninety-nine drops of alcohol for the fifth, and so 
on. These sub-divisions are carried as high as the sixtieth decimal, 
and even higher. Above the thirtieth decimal, which is the decillionth 
part of a grain, the dilutions and triturations are designated as high 
potencies ; and it is claimed that they receive additional power and 
efficacy from the rubbing and shaking employed in making them. 
To. the development of this potency the name of dynamization is 
given. It is but just to state that some of their leading authorities 
reject these high attenuations ; declare that it is a physical impossi- 
bility to sub-divide substances so . infinitesimally, and assign the 
dynamization theor}' to the realms of spiritualism. However, an 
examination of the catalogues of their pharmacists indicate that there 
must be a large sale for these higher preparations. 

The globules or pilules originally used by Hahneman are made of 
sugar of milk, or of sugar, and are immersed in the dilution to 
absorb what little of the medicine can be taken up. These are 
necessarily of an indefinite strength, and are not in favor with the 
mass of the profession, except as suitable for children. Besides 
these, their pharmacists prepare tablets of sugar of milk, which are 
medicated in the same manner. 

In a system of materia medica where the strength of the prepara- 
tions, of a drug may vary from unit to its decillionth part, or even 
^higher, it may be inferred that the dose must vary greatly, according 
to the bias of the views of the practitioner. Hahneman, when he 
originally promulgated his peculiar system, seems to have used full 
doses, and speaks of administering from one-fifth to one-half grain of 
opium, thirty to forty grains of camphor, and half drachm to drachm 
Ndoses of cinchona. From the years 1799 to 1828 he gradually dimin- 
ished the doses by means of his attenuations, until, at the latter date, 
he began to advocate the use of the high potencies above the thirtieth 
decimal, and continued to do so until his death, in 1843. These 
infinitesimals are not approved of by the best educated of homoeo- 
paths ; indeed, some of his followers are uncharitable enough to 
accuse their great apostle of imbecility, senility and dotage in his 
later years. At the present day this school is divided into two parties, 
advocating respectively the high and low potencies. Their journals 
are filled with long, and often ludicrous, dissertations upon these 
points, which at limes assume a bitter and acrimonious character. 
Many frequently give the mother tinctures themselves, which, as was 



204 MEDICAL SOCIETY OF NEW JERSEY. 

previously mentioned, correspond in strength to the tinctures of the 
U. S. Pharmacopoeia ; and there seems to be nothing to prevent any 
homoeopathic physician from giving the same doses thereof as the 
regular school, except the dread of being considered too much of an 
" allopath," a morbid fear of which pervades all their literature. 

It is a cardinal rule in homoeopathy, as laid down by Hahneman, 
that each medicine is to be given singly, and must never be combined 
with another one. He and his immediate disciples directed that one 
dose should be given and its effects noted before it should be repeated* 
without any regard to the time intervening. While homoeopaths 
generally follow the plan of the administration of but a single drug 
at a time, very many of them g^ve two remedies, alternating the one 
with the other, at varying intervals of two or three hours. This, how- 
ever, is a question of dispute among them, the strict constructionists, 
or high potency advocates, claiming'that the adherence to the one-at- 
a-time method is the only true and proper plan. 

There are nine remedies that stand pre-eminent in homoeopathic 
estimation, viz. : aconitum, arsenicum, belladonna, bryonia, mercur- 
ius, nux vomica, phosphorous, Pulsatilla and sulphur. Estimating 
their efficacy by the number of symptoms they produce, sulphur holds 
the highest rank, as Hahneman professed to have observed, or 
accepted of the provings of others, 1,969 symptoms, a number 
greater than that of any other drug. He affirmed that all chronic 
diseases were due to two great constitutional causes. One was 
syphilis, to which he assigned one-eighth of them. As psora or 
scabies, in his day, was a very common disease, the true nature of 
which was then unknown, he attributed it to a constitutional cause, of 
which the skin eruption was but one of its manifestations. To this 
diathesis he gave the name of psoriCy and assigned to it the remaining 
seven-eighths of chronic diseases. Unfortunately for this theory, the 
discovery of the sarcoptes scabei and phtheiriasis pediculi — the 
parasites which produce itch — destroyed the foundation upon which 
it had been built. Nevertheless, his followers have generally accepted 
the psoric theory of disease. Sulphur is the remedy with which they 
combat skin diseases and others "classified under this head. In 
scabies they now allow of its external application ; but in all other 
cases it is to be used internally, in doses from any of its dilutions. 
I f Phosphorous, according to the homoeopathic vocabulary, has a 
pathogenesis of 1,915 symptoms. The primary solution is prepared 



REPORTS OF DISTRICT SOCIETIES. 20$ 

with absolute alcohol, or equal parts of this and ether, so as to be of 
the strength of the third decimal (3X), containing the one millionth 
of a g^ain. It is given as a nerve stimulant ; also in diseases of the 
genital organs, of the alimentary canal, and in pulmonary consump- 
tion. It is administered in doses as low as the one hundredth of a 
grain, and from that to the highest potency. 

Under the name of mercurius, are embraced most of the ordinary 
preparations of mercury. Added to these, are two of their own 
invention. One — mercurius virus — is a trituration of metallic mer- 
cury with sugar of milk, and is analogous to hydrargyrum cum cretae 
of the U. S. Pharmacopoeia. The other — mercurius solubilis — is. 
made by dissolving quicksilver in nitric acid, and precipitating it with 
aqua ammonia. All of these are extensively employed by homoeo- 
paths ; indeed, one of their leading authorities says : " Few medicines 
are so frequently in our hands, and in none have we more confi- 
dence." Mercurius is considered a specific in syphilis, and is given 
in the low triturations even by advocates of high potencies, but not in 
sufficient quantities to touch the gums. 

The remainder of their nine leadmg drugs have been so frequently 
dwelt upon in our own literature as to need no further notice, except 
in the case of Pulsatilla, which has assigned to it a pathogonesis of 
1,155 symptoms. It is a tincture of the whole herb of Pulsatilla 
nigricans or nuttaliana, and is given for almost everything — for dys- 
pepsia, rheumatism, gout, affections of the veins, eyes, genital organs, 
and even to parturient women to rectify false presentations of the 
child in labor. 

There are some medicines obtained from the vegetable and animal 
poisons that are peculiar to homoeopathy. Under the name of rhus, 
they group the rhus toxicodendron, swamp sumach, rhus radicans, 
poison ivy, and rhus venatae — poison ash. These are prepared for use 
in the usual way, by making a tincture and then by dilutions. Rhus 
is recommended in skin diseases : in rheumatism, as an antityphoid 
remedy, and in acute suppurative processes. The dose is from the 
first to the third decimal, except for rheumatism, in which the higher 
dilutions are administered. 

Apis is the poison of the apis mellifua, or honey bee. It is made 
in three ways : by triturating, with sugar of milk, the whole bees, 
dried after killing them in a state of excitement ; by macerating their 
hinder parts in alcohol, and by making a solution of the virus itself in 



2o6 MEDICAL SOCIETY OF NEW JERSEY. 

glycerine or alcohol. It is employed in erysipelas — both constitutional 
and traumatic— diphtheria, scarlatina, cedema of the tongue and 
glottis, and in urticaria. 

The most singular of this class of remedies is lachesis — snake 
poison. Included under this head are the poisons of the viper — 
lachesis trigonocephalus ; the rattlesnake — crotalus horridus ; cobra — 
naja tripudians, and the vipers redi and torva. Medicines are made 
from these by collecting the poisons and triturating them with sugar 
of milk, or by dissolving them in glycerine. The sixth centesimal is 
the lowest dilution employed. It is considered to be applicable to the 
•cure of cardiac troubles, yellow fever, internal hemorrhages, traumatic 
gangrene, septicaemia and malignant spotted fever. 

Opium and Peruvian bark are the stumbling-blocks in the homoeo- 
pathic path. Acknowledged by the world — professional and non- 
professional — to be the two great remedial safety-anchors of the 
human race in its progress towards civilization, they have never been 
able to tit them to their law of similia stmilibus curantur, nor to 
produce any evidence that their infinitesimal doses were of any use, 
save to show the absurdity of their doctrine. Their law of similars 
requires that medicaments of vegetable substances should be made 
of the whole plant, and this necessarily excludes the alkaloids of mor- 
phine and quinine from genuine homoeopathy. 

Opium is classed among their remedies ; and a tincture, with its 
triturations, is directed. Their writers on materia medica and prac- 
tice ignore it as much as possible. The ablest one — Dr. Hughes, Pro- 
fessor of Materia Medica and Therapeutics, in the London School of 
Ho!n<ropatl\y -in a work styled ** A Manual of Pharmacodynamics," 
published in kSSq>, say;^ : "To use opium, therefore, to compel sleep. 
It) ;\llay \yA\\\ or spasiti, and to check excessive secretion, would, with 
us, hr only tolerable when we had no similarly-acting medicine on 
whirh wr oouUl rely for the purpose ; and even then we should feel it 
M question of grave consideration, whether the remedy or the disease 
cMMtstitutrd the gre,\ter evil.*' It is claimed to be homoeopathic to 
leMil y \\\\\\ delirlun^ tremens and v\poplexy, but none of them think it 
woiih wlnlr lo i\an\e the dose. 

UndfM the n;une of t^'hina. is placed cinchona or Peruvian bark. 
llMluienirtM e\prnn\enled with it by his method of provings, and 
H'pmleil ii lo be l\on\a op,Uhiv^ to certain unimportant diseases not 
\\i , J t^-^.n V (n n,in\e heu^ ; )n»t to malarial fevers he found that it was 



REPORTS OF DISTRICT SOCIETIES. 207 

not only inapplicable, but he attributed to cinchona poisoning all the 
sequelae which are now known to be the result of miasmatic disease, 
when let alone or inefficiently treated. This was the accepted doc- 
trine so late as 1862. In a work on the theory and practice of medi- 
cine, by Arthur Lutze, a high German authority, translated in that 
year by Dr. Hempel, of New York, quinine is denounced, and, in a 
repertory of intermittent fevers, he gives a table of thirty-nine drugs 
whose symptoms are similar and appropriate to the cure of these 
fevers and their complications, of which seventeen are devoted 
exclusively to the treatment of the overdose and abuse of cinchona 
and quinine. But the world had moved. Miasmatic countries have 
been explored, and settled by the aid of cinchona. Armies have made 
successful campaigns on a diet of quinine sanctioned by governments. 
By it, Livingstone and Stanley were enabled to traverse the deadly 
regions of central Africa. These were facts that could no longer be 
ignored ; consequently, in Hunt & Marcy's •* Homoeopathic Practice 
of Medicine," published in New York in 1865, we find that the power 
of quinine as a prophylactic against miliaria is acknowledged, and its 
employment in intermittents assented to, with the reservation that 
" calisaya bark is superior to quinine in all bilious fevers, possessing 
powers very different. Half-grain doses have always, in our hands, 
proved effectual.'' Dr. Lillienthal, of New York, in a volume on 
homoeopathic therapeutics, published in 1879, approves of cinchona 
" in fevers with regular type, complete intermission and regular 
paroxysm of chill at the same hour." Finally, in 1880, Dr. Hughes, 
of London, in his book previously mentioned, says, under the head of 
cinchona : " The testimony to its efficacy in malarial poisoning in 
whatever form it may assume is loud and uniform. To begin with it 
is an almost certain prophylactic. Its use renders possible the pene- 
tration into certain regions which would otherwise be deadly to the 
traveler. Then it is no less beneficial, whatever be the type of the 
malarial fever — whether intermittent, remittent or continued." It is 
curious that these writers refrain from naming the appropriate dose 
of cinchona and quinine for malaria, seemingly content to enlighten 
the student of their literature with glittering generalities, and a cau- 
tion that large d,oses are dangerous. 

The " American Homoeopathic Pharmacopoeia " contains 780 reme- 
dies. These, with their many dilutions and potencies, greatly exceed 
in number the 997 preparations of the U. S. Pharmacopoeia. The 



208 MEDICAL SOCIETY 0/ NEW JERSEY, 

number of pharmacists in the United States to prepare and distribute 
these cannot be ascertained ; for, while ten years ago the business 
was concentrated in a few hands and confined to the larger cities, 
their number has recently greatly increased, and they are now extend- 
ing to the smaller cities and large towns. The homoeopathists claim 
that the number of their practitioners in this country is 10,000 — being 
nearly one-fifth of the whole number of pliysicians enumerated in the 
census of 1880. As it is their custom to carry their medicines with 
them, it is evident that dnly a small percentage of these can be used 
by the individual prescribes and that the increasing demand which 
multiplies pharmacies comes from the public who are rapidly learning 
to use homoeopathic remedies. 
Haddonfield, N. J.. April 21st, 1884. 



CAPE MAY COUNTY. 
To the C/uiirman of the Standing Committee y &c, : 

There has been but little difference in the general 
health of the people from former years ; indeed, we seem 
peculiarly favored as to the amount of sickness and in 
the fatality attending it, for if you will examine the sta- 
tistical reports of the State Board of Health, our death- 
rate will be found below any county in the State. The 
usual diseases have prevailed during the different seasons. 
No severe epidemics of ^y character, but about the 
usual amount of ditTerent diseases endemic in this region. 

Dn B» T» Abbott, of Tuckahoe, reports " a moderately- 
scvcrc epidemic of scarlatina during the latter part of the 
winter and spring of iS$5. continuing until the month of 
May* n\v\ny of the cases of :r.arked severity with compli- 
cations, the most severe of wl::ch was diphtheria; few, 
however* puned fata\ Many were left with troublesome 
svv|UvIa\ Puut\g the fall and early winter it broke out 
av:atu in a miUl toruK atui d:cd out during the winter. 



REPORTS OF DISTRICT SOCIETIES. 209 

We have also had a few sporadic cases of chicken-pox 
and measles, but nothing approaching an epidemic, and, 
as usual, some few cases of diphtheria. Some few cases 
of bilious remittent and intermittent and typhoid fevers, 
but less, on the whole, than any previous year during my 
practice in the county (eleven years)." 

Dr. P. M. Way, of Seaville, writes : " We have enjoyed 
a year of general healthfulness in our township, what 
sickness we have had consisting principally of our 
ordinary endemic diseases. During the winter and 
spring, however, diseases of the respiratory organs have 
been more than usually prevalent, especially pneumonia 
and bronchitis ; very few have proved fatal. Rheumatism 
has been rather more common than usual. Treatment 
with salicylate of soda has been uniformly successful." 

Dr. I. M. Downs, of Cape May C. H., writes: ** The 
sanitary condition of the middle township has been 
unusually healthy during the past year. No epidemic of 
wide-spread nature has appeared amongst us. During 
the latter part of summer and early fall, a slight run of 
scarlet fever prevailed on the bay shore, of a very mild 
character, and no deaths occurred. During the spring 
the usual influenzas, catarrhal pneumonia and acute 
bronchitis prevailed, the result of the protracted cold and 
damp weather ; most of them easily and quickly thrown 
off when the subject was young and healthy ; with the 
aged and infirm the recovery was more difficult and pro- 
tracted. Cases of diphtheria have been rare during the 
year, only a few sporadic ones occurring ; none fatal. 
Typhoid fever has been very rare." 

In my own part of the county we have experienced the 
same general immunity from epidemics of every kind. 
A few sporadic cases of the exanthemata have occurred. 
A little whooping-cough, mumps and diphtheria, &c., but 

14 



210 MEDICAL SOCIETY OF NEW JERSEY. 

not more than may be found any year. A few cases of 
typhoid fever, some of them very severe, but ending in 
recovery. The usual catarrhal troubles consequent upon 
a cold, damp winter and spring prevailed to some extent. 
The summer months were peculiarly deficient in the usual 
bowel affections in both children and adults. Influenza 
had quite a number of victims, but yielded readily to 
treatment. Intermittent and remittent fevers have been 
fewer than common. In short, the year past has been 
rather exceptional than otherwise, for the general health 
of the people in this county. 

Dr. Abbott, in his communication, speaks of the appar- 
ent increase of malignant morbid growths in the coast 
counties of the State, and queries as to the cause. He 
also mentions as having occurred in his practice a number 
of cases interesting to the gynoecologist, but gives no 
particulars. 

Dr. Downs relates an interesting case of ** Granular 
Degeneration of the Omentum," in a man 6"] years of 
age, running through a course of six years, and greatly 
puzzling his attendants by the different symptoms mani- 
festing themselves at different times, and finally dying 
afiparently of inanition, eating nothing of consequence 
for a month previous to his decease. It was probably a 
case of encephaloid degeneration of a cancerous nature. 
We had a very similar case in this part of the county, 
running over some four years. Post-mortem examination 
revealed the same condition of omentum, enormously 
thickened, and a solid mass of encephaloid disease. 

We have had, in this city and vicinity, three cases of 
puerperal albuminuria during the past year, in which the 
kidneys ceased to secrete almost entirely. In two of 
them, convulsions followed, and in all three premature 
labor was induced — one at seven and one-half months, 



REPORTS OF DISTRICT SOCIETIES. 211 

one at eight months, and one at eight and one-half 
months. The child was born dead in the case unattended 
with convulsions. In the other two the children were 
both living — one a boy and the other a girl, and are nice, 
growing children, as likely to live as any. The mothers 
all recovered without any very untoward symptoms. 

We had also, some time ago, a case of twins with a 
double uterus. Children born about four hours apart — 
the first with a natural, easy labor, and the other by 
podalic version. One child perished on third day with 
hemorrhage of the umbilical cord, and the other is a fine, 
healthy, growing boy, bearing the name of your reporter. 

We have, as yet, no medical society in this county to 
greet the State Society at its meeting in this place in 
June next, but I trust the reception by the physicians of 
the county will be so hearty that the absence of a regular 
organization will not be felt ; and I am happy to say that 
the preliminary steps have been taken for the organiza- 
tion of a county society, and an application will be made 
to the State Society, at its coming meeting, for the 
requisite authority so to do, so that hereafter we may be 
represented by a regular delegate and have a regular 
reporter, who may discharge his duties much better than 
I have ever been able to do. 

VIRGIL M. D. MARCY. 



A Case of Internal Abscesses. 

BY DR. G. G. CARLL, OF DENNISVILLE. 

The wife of ex-Senator R. L. L., fifty-six years of age, was taken 
sick on the 15th of last December. She was first taken with severe 
pain in the abdominal region, which was most acute along the right 
side. This continued until a general peritonitis seemed to be aroused. 
The pain extended to her right shoulder, and was so excrutiating that 



:3I2 MEDICAL SOCIETY OF NEW JERSEY. 

I was obliged to subdue it with frequent injections of morphia. On 
the same side, just anterior to the lumbar region, now appeared a 
spot about the size of the top of a small teacup* rather oblong in 
shape, and extended, I thought, towards the centre and left side of 
the abdomen. 

The case now presented an alarming appearance. The intense 
sufferings of the patient continued, with now and then quite a per- 
ceptible chill. Prof. Penrose was called in consultation. By the time 
of his arrival the tender spot could be felt very perceptibly, and was 
diagnosed by Dr. Penrose as an abscess in the region on the line or in 
the folds of the colon. It was his opinion that the case was liable to 
prove fatal, should it rupture without gaining an external outlet in 
some way. The case continued in this condition for nearly a week 
longer, when the abscess opened into the colon and was discharged 
per anum. We looked upon this event as very favorable, and antici- 
pated convalescence soon, but instead, our patient passed into a low 
typhoid slate. The tongue took on a dark, dry and cracked appear- 
ance. The right parotid swelled to an enormous size, and eventually 
had to be opened. Symptoms of hemorrhage from the bowels were 
observed. The small amount of blood that was passed I presume 
came from where the ulcer ruptured into the colon. She continued in 
this state for about eighteen days, during which she was delirious, 
imagining herself away from home in a distant part of the country, 
and was constantly beseeching me to return her to her home and 
friends. She would call for her slippers and dress, and make g^reat 
exertions to get out of bed, and then pass into a low, muttering delir- 
iuui, with her head constantly rolling from one side to the other and 
with her arms in continual motion. From this condition, however. 
she rallied, and her prospects seemed to brighten. Soon the pain 
returned in the left side, and I detected another oblong tender spot. 
about as near as I could tell, two inches above the first. Now I will 
not attempt to go through with all the symptoms that attended the 
progress of the second abscess, as they were very nearly or quite the 
b^une as in the rust. It foriunately broke into the colon again, and 
was discharged through the bowels. The patient, as before, passed 
into the low t)i)hoid state, with the dark, dry and cracked tongue and 
with the wandering of mind. The parotid gland again suppurated 
and was opened. Thus she remained about sixteen days, when she 
again rallied and seemed to be in a fair way to convalescence. She 
improved just ^o far and :lien stopped. 



REPORTS OF DISTRICT SOCIETIES. 213 

She complained most of the time now with dull, heavy pain in her 
right hypochondriac region, particularly when she laid on that side. 
We examined the parts carefully, and could not detect anything 
wrong in the lung by auscultation and percussion. It seemed too high 
up for the liver. Finally we located the trouble, whatever it might 
be, between the lower surface of the diaphragm and the upper surface 
of the liver. Prof. Penrose first held the opinion that it was located 
above the diaphragm, but afterwards decided it where I have men- 
tioned. She continued in this condition for nearly four weeks, when 
she began suddenly to raise large quantities of very offensive pus 
through her right lung — so offensive that the assistants were unable 
to stay in her room with any comfort. The room was well ventilated, 
and every precaution taken to keep the air pure. This expectoration 
continued between six and seven weeks, when it began to be less 
offensive and smaller in quantity. During this time her mind was, as 
far as I could see, perfectly clear ; her memory only seemed to be 
deficient. She could not remember the time of day when told, nor 
the day of the week. She had no typhoid symptoms ; her tongue 
had a healthy and moist appearance ; her stomach and bowels acted 
naturally ; her lower limbs were slightly cedematous. From this 
time sunshine began to come in, and lessened the burden of anxiety I 
had carried so long. Her appetite slowly improved and convalescence 
gradually advanced. To-day (middle of May) is five months since 
she was first taken. She is able to walk over the house, and rides out 
on pleasant days in a comfortable carriage. I will here say that her 
pulse ran, during her typhoid stages, at or near 110°, and her tem- 
perature between 103 and 104. During the discharge of the last 
abscess it was not quite up to the normal, with her pulse ranging from 
80 to 96. 

The treatment was conducted on general principles. Her pain was 
relieved, of course, with morphia, given both hypodermically and by 
the stomach. In the typhoid states she was given the oil of turpen- 
tine internally, with turpentine stupes and warm fomentations applied 
freely to the abdomen. Brandy punch, beef tea and quinia sulph. 
given at proper times. During the last stage, or the raising of matter 
through the lungs, quinia from 8 grs. to 12 grs. a day, tine, ferri 
chlorid., comp. tine, iodin., and tine, iodin. externally, with the best 
French brandy, allowing her to eat any kind of food for which she 
had a desire, and as much as she wished, as nothing seemed to disa- 



214 MEDICAL SOCIETY OF NKW JERSEY. 

gree with her, Deef tea was freely used when she would take it, and 
large quantities of new milk and of butiermilk most all the time. 
Thus the case was conducted to what 1 think will eventually be a 

favorable termination, 



A Case of Double Uterus. 

BV VIRGIL M, D. MARCY. 
Was called at 2 o'clock P. M.. March lolh. to attend Mrs. M. in her 
third conliuemeiit. She was about 3; years of age, large and fleshy, 
weighing about 190 pounds. Her former labors were somewhat diffi- 
cult and tedious. On my arrival, found the pains active and strong, 
ami a iligital examination disclosed an os ver)' nearly dilated, relaxed 
ami dilatable. In a short time ruptured the membranes, and by 3.30 
P. M. she gave birth to a male child, weighing about five pounds. 
After the birth of child, found the abdomen but little diminished in 
size, and at once examined for another child. The fingers failed lo 
reach a child or lo explain the cause of an enlarged uterus. Nor did 
an external examination solve the problem, as there was no motion of 
child ; nor could palpation discover the outlines of one. the amount 
of adipose tissue interfering. There was great tenderness over the 
whole abdomen, from the amount of stretching of the tissues as well 
as of the genitals. There being no hemorrhage, decided to wait a 
while for further ijevelopments. At 7 P. M., there being no further 
action of the uterus, on consultation with Dr. James Mecray, we 
decided to ^etheriie and make an exploration of the cavity of the 
uterus, and at the same time remove the undelivered placenta. On 
rarrvinir ih^ li:md Up to the fuiidus following the cord, it came in con- 
ler child, high up on the right side of the mother, but 
;i the b.iacJ h\ a septum, so that I could not touch the 
ilhdniwing the hand slowly, the fingers resting on the 
one-quarter of the distance from the os to the fundus 
iiig. which proved to be a second os. Passing the hand 
I came in contact with (he head of a child, the waters 
i! previously. Secured the feet, turned and delivered 
1 males, and both li\ ing. Before she came out from 
ithetic. removed the placenta from first one uterus and 



REPORTS OF DISTRICT SOCIETIES. 21 5 

then the other, it contracting on the hand in removing the second 
placenta. She had a reasonably good convalescence. On the third 
day after birth, the eldest child perished from hemorrhage of cord and 
umbilicus, ligatures and styptics failing to control it. The other sur- 
vived, and is a fine, healthy, growing boy. 



A Case of Encephaloid Disease of the Omentum. 

BY I. M. DOWNS, M. D., CAPE MAY C. H. 

Mr. S., aged 67 years, had been confined to the house, and a great 
part of the time to his bed, for the past six years. The examination 
of his case had caused a number of physicians to give various 
opinions. Palpitation and distress in the region of the heart at one 
time would seem to establish the opinion that some organic disease of 
that organ was the cause, although no very distinct murmurs could 
be detected. Marked symptoms of indigestion — such as pyrosis, 
vomiting of food and general uneasiness after eating — would point at 
other times to the stomach as the seat of the trouble. For a short 
period at one time, acute mania confused the diagnosis, and led the 
attention naturally to the brain as the probable seat of the trouble. 
During the whole time of his sickness, a distinct soreness existed in 
the abdomen, with some little enlargement and hardness between the 
pubis and umbilicus. No ascites of any amount ever existed in the 
history of his case, although at times a slight accumulation of fluid 
could be detected on each side of the abdomen, low down, when he 
lay on his back. The soreness and fulness was examined from the 
first, and was supposed to be a tumor of a malignant type, connected 
with either the liver or stomach ; but as it did not perceptibly increase 
in size, and the number of years passed in which tumors of a malig- 
nant growth prove fatal, this opinion was abandoned. Two or three 
attacks of hemorrhage from the lungs complicated his case. At vari- 
ous times in his history, in this way six years of life were passed 
under the influence of various drugs. Morphia was used only mod- 
erately ; digitalis, in small quantities, appeared to give the greatest 
amount of relief and satisfaction to the patient. There was no swell- 
ing of the extremities or very serious cough, and no expectoration, 
during the last year of his life. The matters vomited consisted of a 
large quantity of yellow, bilious matter, without any admixture of 



2l6 MEDICAL SOCIETY OF NEW JERSEY. 

food whatever, about one pint constituting the quantity, and at inter- 
vals of about three weeks. Much relief would be experienced after 
the evacuation of the stomach. The bowels were alternately consti- 
pated and loose, and when loose, the dejections appeared to consist 
of the same material as that vomited. No affection of the liver 
could be discovered by the closest examination. The patient died 
from clear exhaustion, as the appetite failed entirely one month before 
his end. 

A post-mortem examination was made twenty-four hours after 
death. On opening the abdomen, a small quantity of fluid was found 
in the peritoneal sac ; liver, normal in size and healthy in structure ; 
stomach contained about one pint of dark-yellow fluid, such as was 
frequently vomited ; coats of stomach on lower and anterior surface 
highly congested, and evident signs of chronic gastritis, but no ulcers 
observable. The omentum was found to be the seat of the trouble 
that had affected him so long. It was enormously thickened, especi- 
ally on the left of the median line, very granular, and much broken 
down in its condition. This extended to the stomach, the external 
coat of which was in much the same condition, and corresponded 
with the red and inflamed mucous membrane of that organ. The 
kidneys were normal ; the heart was very much atrophied, but no 
valvular disease could be detected ; the lungs were normal. No 
microscopic examination, I am sorry to say, was made of the growth, 
and it was decided to be one of granular degeneration of the omen- 
tum. The length of time the patient lived with this affection makes 
it one of remarkable interest. That it was cancerous, was strongly 
supposed at the time of the post-mortem, the length of time the case 
continued being the strongest argument against this presumption, 
although the complexion and general cachexia were cancerous. 



CUMBERLAND COUNTY. 
To the Chairman of the Standing Committee, &c, : 

During the past year the number of deaths in Cumber- 
land County was 14.39 P^'^ 1,000, while m 1882 it was 
20.94, so that the amount of sickness was evidently much 



REPORTS OF DISTRICT SOCIETIES. 217 

All our physicians believe that tobacco injures the 
nervous system, aggravates cardiac disease and, as Dr. H. 
W. Elmer says, it does much injury to throat and chest 
affections, and makes neuralgic and dyspeptic conditions 
a great deal harder to treat. 

An opinion was requested of the profession respecting 
the mental force and power of the drunkard's offspring, 
as compared with those in the temperate. One says the 
drunkard's nerve centres are weakened and are incapable 
of imparting a more healthy tone than they possess. Dr. 
H. W. Elmer says intemperance alone is a bad factor in 
a parent ; and if to this be added a scrofulous cachexia 
or a venereal taint, the offspring will be the degenerate 
plant of a bad vine, and must yield before the superior 
forces of more healthy physical and mental organizations. 

The summer complaints of children were less severe 
than usual, and the mortality less by 24 per cent. 

It seems the compilers of our mortuary statistics class 
croup and diphtheria under one head. This may save 
thinking, but surely it does not assist scientific classifica- 
tion. All physicians know that numerous cases of diph- 
theria have no croupal qualities whatever ; also, that 
thousands of cases of croup have no diphtheritic char- 
acters at all, either when mild or fatal. Tliis is certainly 
a serious defect, and no amount of authority or number 
of years of following the practice can make the habit a 
valid one. 

Taking our statistics as a guide, it is surely very grati- 
fying to notice the steady decline in the number of fatal 
cases of phthisis in our county. Last year it was 90, 
while in 1879 ^^ ^^^ ^^ 5 ^^^ ^^^ number has continued 
on a constantly-decreasing scale to the present. 

The weather statistics from May, 1883, to May, 1884, 
will be found as follows, and are believed to be accurate : 



NKW JERSEY. 



Days. aygraai. 



REPORTS OF DISTRICT SOCIETIES. 219 

ESSEX COUNTY. 
To the Chairman of the Standing Committee^ &c, : 

Far less sickness than usual is the universal report from 
all sections of the county. Especially is this true of the 
last two months. Many physicians have almost " nothing 
to do," and even those who are the busiest have more 
leisure than usual. Whatever other causes there may 
have been, one cause is quite generally and, perhaps, 
correctly assigned, viz. : a steady cold winter and an 
unusual depth of snow, which covered the ground con- 
tinuously during January and February. 

The following table is a summary of the meteorological 
records made at South Orange, for the year covered by 
this report : 

Temperature. Rain and Aver. Depth 

. • ^ Melted Rainfall of 

1883 Max. Min. Mean. Ave. I5yrs. Snow in for Snow in 

deg. deg. deg. deg. Inches. isyrs. Inches. 

May.... 84 42 59.77 60.90 2.49 2.91 

June 90 52 69.78 70.06 5.50 3.16 

July 92 59 77.32 73.76 2.23 4.50 

August 90 50 68.09 71 58 2.50 5.07 

September.. 84 44 61.53 63.69 4.80 4.23 

October 84 34 52.30 53.41 5. 3.53 

November... 72 18 42.66 40.38 .95 3.36 

December... 54 i 31-55 28.99 4.06 3.88 26 
1884. 

January 44 4 23.83 28.21 6. 3.86 20. 

February 58 4 33- 16 30.16 4.85 3.88 9. 

March 64 4 36.37 36.38 4.28 3.90 5. 

April 76 32 48. 48.25 2.35 3.08 0.5 

There were fifty days of sleighing during the winter, 
while the average is only twenty-six and one-half. The 
total depth of snowfall was fifty-five inches. The average 
for fifteen years is only thirty-eight and one-half. 

Owing to some local causes, there were more cases of 



220 MEDICAL SOCIETY OF NEW JERSEY. 

diphtheria in this vicinity than usual during the winter ; 
and many of these cases were of the most malignant 
form. The mortality was, therefore, unproportionately 
large. The extension of the membrane into the larynx 
and trachea was of frequent occurrence. Tracheotomy 
was often done and, except as affording temporary relief, 
was uniformly unsatisfactory. I have, however, one case 
which promises to be an exception. It is now one week 
since the tube was inserted, and the child (two years old) 
is almost well. 

Typhoid fever, which prevailed quite extensively one 
and two years ago, has been of rare occurrence. There 
have been no epidemics of any of the eruptive fevers. 
Scarlet fever and measles have occurred in a few localities, 
but have shown no disposition to spread. The rheumatic 
affections have been spoken of by many physicians as 
being of rather more frequent occurrence this spring than 
usual. Such testimony is in accord with my own experi- 
ence. While these cases are seldom of the acute grade, 
they seem to require pretty full doses of the salicylates. 

Iodoform as a dressing for wounds has held sway in the 
hospitals for over a year. It is now giving place to a 
more fashionable, and certainly more agreeable disinfect- 
ant, viz. : the bichloride solution (i to 2,000). This lat- 
ter preparation has also been used satisfactorily as a spray 
for the throat, in the treatment of diphtheria. 

Among the things that are new is rectal anaesthesia. 
It has been tried thus far in only two cases in our hos- 
pitals. In each of these cases the apparatus was rather 
hastily extemporized, and allowed escape of the ether. 
There was, therefore, a waste of time and material. 

Case /. At Memorial Hospital, Orange ; service of Dr. 
Wm. Pierson ; male, aet. 25 ; amputation of finger for 
gangrene ; traumatic ; anaesthesia produced in eighteen 



REPORTS OF DISTRICT SOCIETIES. 221 

minutes ; ether continued thirty minutes ; no vomiting ; 
circumference of abdomen increased three inches by dis- 
tension with ether gas. During the next two or three 
days, fever; temperature, 102^ to 105^; very frequent 
bloody passages and great prostration ; grave fears for 
the patient's life ; ultimate recovery. 

Case 2, In my own service at St. Barnabas' Hospital, 
Newark ; child, aet. 3 years ; genu valgum ; osteotomy of 
tibia ; time, forty-five minutes ; quantity, giv ; partial 
anaesthesia ; slight vomiting ; considerable prostration 
for several hours ; no bad after-effects. 

Watching these two cases, and reflecting upon others 
reported, we may summarize the advantages and disad- 
vantages of this mode of administration as follows : . 

Advantages — 

(i) No disagreeable sense of suffocation. 

(2) No subsequent nausea. 

(3) Operations on the face unimpeded. 

Disadvantages — 

(i) The danger of giving an overdose. Large quan- 
tities of the gas may be retained in and ab- 
sorbed by the intestines after the withdrawal 
of the rectal tube. 

(2) The prolonged subsequent prostration. 

(3) The frequent occurrence of severe intestinal irri- 

tation 

It is perhaps too soon to say that these objections are 
insuperable ; but, unless some way to obviate them is 
speedily devised, the era of rectal anaesthesia will be 
short. 

Dr. Chambers, of East Orange, reports that *' the 
health of East Orange during the past year has been 
exceptionally good. There has been no prevailing dis- 



222 MEDICAL SOCIETY OF NEW JERSEY. 

ease. Malarial and diarrhoeal diseases have not been 
prominent, notwithstanding the fact that for the past five 
months the ground was literally soaked with water. 
Many cellars contained water, and not a few wells were 
contaminated from cesspoels. Three hundred and fifty 
families are supplied by the water company, and the 
necessity for sewerage is becoming felt/* 

Dr. Whitehorne, of Verona, writes : *' During the past 
year the health of the township of Caldwell has been 
remarkably good. No epidemic of a serious nature has 
prevailed. Measles in a mild form was imported into the 
district of Fairfield in the latter part of February, from 
Paterson, and was very general. There has also been a 
good deal of whooping-cough, together with follicular 
tonsillitis. During the winter months pneumonia, in a 
catarrhal form principally, was frequent ; but the great 
feature characterizing all the foregoing has been their 
comparative mildness. I have not heard of any diph- 
theria or scarlet fever. Diseases of a malarial type have 
been infrequent. 

" In this connection I would like to call your attention 
to the present condition, hygienically speaking, of the 
Newark City Home, located at Verona, in which there 
are domiciled about i8o children. Up to the beginning 
of last fall, a large portion of the water drank by the 
inmates was furnished by a reservoir largely supplied by 
surface drainage, the water being pumped up into the 
building, and distributed from a large tank in the top of 
the building. As a consequence, it now seems, malarial 
disturbance was frequent, evinced in the shape of mild 
forms of intermittent and remittent fevers, they proving 
generally amenable to treatment, but the former being 
prone to recur again and again in the same individual. 
There were also a number of cases of digestive disturb- 



REPORTS OF DISTRICT SOCIETIES. 223 

ance, principally nausea and vomiting, which often proved 
quite tedious, and were the cause of a good deal of 
suffering. In order to increase the amount of water 
available, the Superintendent — Mr. C. M. Harrison — 
made a * series of tests upon elevated ground west of the 
Home, and found underneath a bed of drift material, 

• 

varying in depth from eleven to eighteen feet, a stratum 
of gravel, which rested upon another of impervious clay. 
The latter varied in depth from three to five feet ; the 
former, from six inches to three feet. The gravel stratum 
was water-bearing ; and where the greater depression 
was found in the clay beneath, there was found the 
greater depth of gravel, and more marked indications of 
water. A well twelve feet in diameter was sunk to the 
depth of twenty feet, which, in the latter part of July, 
yielded over i,ooo gallons of water daily. Encouraged 
by this showing, the committee in charge, of which Dr. 
Ill was chairman, concluded that it would be well to 
uncover the gravel stratum for a distance of one hundred 
feet both south and north from the well. This was 
accomplished by ditches three feet wide and from four- 
teen to eighteen in depth. The portiqn to be utilized for 
water supply was walled up and covered with a mortar 
made from cement. Owing to the irregularities of the 
clay bed, a second well became necessary. Into these 
the underground conduits convey the water collected 
from the section above described. The flow of water 
from these sources is more than ample for all the wants 
of the institution during the greater part of the year, and 
the water itself is singularly pure and soft.* 

" The above is an extract from the Superintendent's 
annual report. Since beginning the use of the new water 
supply there has not been a case of illness which seemed 
traceable to malarial poisoning, nor have there been any 



224 MEDICAL SOCIETY OF NEW JERSEY. 

of the old cases of nausea ; and this extending over a 
period of six months. These facts, taken in connection 
with others which have been adduced of late by different 
observers, seem to indicate that the ingestion of surface 
water, charged as it is often necessarily with organic mat- 
ter in solution, is a potent factor in the creation of the 
various forms of so-called malarial disorders." 

Dr. J. J. H. Love, of Montclair, writes : ** The health 
of this township during the past year has been better 
than it has been for any similar period during the past 
twenty-five years. We have had no epidemics of any 
kind, except that during the early summer of 1883 
whooping-cough prevailed in certain localities, and during 
the past winter, in the northern portion of the town, 
measles of a mild type ran through the families whose 
children attended the district school located in that 
vicinity. Winter set in in earnest about the 20th of 
December, and we had steady cold weather, without any 
thaws, until February Sth. This low range of the ther- 
mometer for so many weeks, with little change, was 
very favorable to the public health. We had fewer cases 
of disease of the respiratory organs than for many years. 
Since that time the majority of the cases coming under 
my observation were rheumatism and diseases of a 
rheumatic origin. Malaria and malarial diseases have 
been unknown, except in a district of territory in the 
northern part of Bloomfield township, through which 
runs the Morris canal. Cholera infantum and diarrhoeal 
diseases were exceptionally few last summer and fall. I 
have come to believe that the mothers of to-day have 
learned to feed more intelligently their infants than they 
did twenty years ago. I have no peculiar views to pre- 
sent in regard to the causes or the cure of epidemics. I 
believe that contagious diseases can — by isolation, by the 



REPORTS OF DISTRICT SOCIETIES. 225 

proper use of disinfectants, by attention to cleanliness in 
the bedding and clothing of the sick and attendants, and 
a strict and eternal vigilance on the part of the attending 
physician — be, in a great majority of cases, confined to 
the house in which they break out — almost, I might say, 
to the first patient or patients taken down/* 

Dr. Love also makes some statements of interest which 
were called forth by recent discussions pn puerpural fever. 
" Some years ago I had, within a few weeks time, five 
cases of puerpural fever in different parts of the township. 
Three of the cases died, notwithstanding proper antisep- 
tic means were used from the beginning, and the medica- 
tion had been large doses of quinine during the intermis- 
sions, and acid mixtures, anodynes, &c., when required 
during the exacerbation of fever. I then made an 
entire change in my clothing, using antiseptic baths for 
myself frequently, and refused to attend any cases of 
labor for a month. The two remaining patients were put 
on the salicylic acid treatment. The results were satis- 
factory, the patients making a complete recovery. 
Whenever now a case of puerpural fever begins to show 
itself I begin the use of salicylic acid, and invariably with 
good results. I continue the medicine for several days 
after all signs of the fever have abated." 

Dr. McDermott, of Newark, writes as follows : ** Dur- 
ing the autumn and winter months I met quite a number 
of cases of scarlatina and diphtheria and diphtheritic 
croup. These diseases were sporadic in character, occur- 
ring here and there at different times. There were few 
deaths from either scarlatina or diphtheria, except where 
the latter invaded the larynx. Of the causes of death 
among children, beginning with the autumn months, up 
to the present, the most frequent, as far as my observation 
extended, was due to laryngeal stenosis or obstruction. 

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REPORTS OF DISTRICT SOCIETIES. 22/ 

T. R. Chambers ; ** A New Mode of Malarial Poisoning,** 

by Dr. J. W. Stickler, and " Chorea," by Dr. J. H. Clark. 

WM. J. CHANDLER, Reporter, 
South Orange, May 14th, 1884. 



Chorea. 



REPORTED BY DR. J. HENRY CLARK, HOUSE PHYSICIAN, 

ST. BARNABAS' HOSPITAL. 

The following is a brief review from the history of a case of chorea 
admitted into St. Barnabas' Hospital in February last, which presented 
features of particular interest, mainly because of its abrupt com- 
mencement, and the fact that the disease was severe and general from 
the first. 

February loth, John M., 7 years old, has never been in very good 
health — always needing attention. Nothing unusual has been noticed 
regarding his health until two weeks ago, when, on returning from 
school one day, he was observed to be fretful and fidgety, with singular 
muscular actions about muscles of face, growing abruptly worse — so 
much so, that in twenty-four hours the choreic movements became 
general, involving alike the muscles of the neck and face, upper and 
lower extremities, the severity and persistence of the muscular actions 
depriving the little patient of rest, the convulsions becoming so severe, 
with but momentary intermissions, that but very little sleep could be 
obtained. The appropriate remedies were administered at home 
(bromides, arsenic and morphine), but without receiving response or 
abating the severity of the disease. The surroundings of the home 
being such as to forbid extensive treatment and proper nursing, the 
case was sent to the hospital. 

Admitted two weeks after beginning of attack. Moderately well- 
nourished, pale, anaemic child. Face and head scratched and lacer- 
ated from finger-nails. The choreic movements are constant and 
general, as has been stated. Grimaces and distortions of the features. 
Speech is slow, thick and indistinct, and mastication and deglutition 
are difficult. Can only be fed by spoon, and very little at a time. 
Cannot stand upon his feet ; can only lie or sit up, when held, in bed. 
Bowels have not moved for two days. Takes what nourishment is 



228 MEDICAL SOCIETY OF NEW JERSEY. 

given, seemingly with a relish. Convulsions are still so violent, and 
the intermissions so short, that marked prostration and exhaustion are 
produced. Urine is passed much in excess in amount. 

Treatment. — Admitted lo A. M. ; ordered hot mustard bath ; 
enema, warm water and soap ; 6:. Ward morph. (U. S. P.) 3j and 
M. chloral hyd. (gr. x) 3j at 1 1 A. M. and 3 P. M. At 6 P. M. no 
change in condition ; has had no sleep ; bowels have moved ; ordered 
M. chloral hyd. (gr. x) 3i per rectum, 11 P. M. ; half an hour later, 
same per orem. 

Feb. II. Slept and was quiet at intervals of an hour ; had through 
the night, M. chloral hyd. (gr. x) 3j at 4 and 8 A. M. ; ordered for the 
day, M. bromide (gr. x) oj and Ward morphine (U. S. P.) 3ss 9. 2. h., 
brandy 3j 9. 2. h., and also liq. arsenite pot. M. V., ferri. et amm. 
citrate gr. viii, syrup, &c. ; t. i. d. before meals. 

Feb. 12. Passed a bad night ; three or four violent convulsions, last- 
ing each an hour ; had but little rest ; takes his nourishment well, 
which consists of milk, eggs and beef tea. Ordered for the day. Ward 
morphine (U. S. P.) 3j, M. chloral hyd. (gr. x) 3j, 9. 2. h., until quiet ; 
repeat when necessary ; brandy and *' sf." M., same. 

Feb. I J. Had a good night. Eight doses of the chloral and morph. 
were given up to 11 P. M. There is a marked improvement in the 
patient's condition this morning. Is quiet and controllable ; muscular 
movements are not so strong or near so violent, and only occur at 
long intervals. Ordered for the day : diet, " sf." M. (arsenic, &c.,) 
and brandy, same ; M. chloral hyd. (gr. x) 3j 9. 3. h ; all other medi- 
cine stopped. 

Feb. 14. Same as yesterday ; passed a good night. 

Feb. IS' Still further improvement. Ordered for the day : M. chlo- 
ral hyd. (gr. x) 3i, t. i. d. (only) ; liq. arsenite pot. increased to M. vi ; 
brandy, 3i 9. 2. h. 

Feb. 16. Still more marked improvement this A. M. ; slept through 
the entire night. Ordered M. chloral hyd. (gr. x) 3i h. s. (only). 

Feb. 77. Doing well ; increased liq. arsenite pot. to M. vij, t. i. d. 

Feb. 18. Doing well ; increased liq. arsenite pot. to M. viij, t. i. d., 
and chloral 3i, h. s. (only). 

Feb. ig. Improving. Ordered M. chloral 3i, p. v. n. (only) ; in- 
creased liq. arsenite pot. to M. ix, t. i. d. 

Feb. 2y. Marked improvement ; has not had chloral in three days, 
and only twice since the 20th inst. ; eye-lids are little puffy ; liq. arsen- 



REPORTS OF DISTRICT SOCIETIES. 229 

ite pot. reduced from M. ix to vij M. ; eczema of edges, lids and catar- 
rhal conj. ; both eyes have been exosted for two weeks ; have been 
corrected by the use of white salve. 

March J. To-day is noticed, on right buttock, a large, inflamed 
surface ; center indurated ; very painful ; extending to inner aspect of 
thigh, and involving the teste, &c. ; ordered large poultices. 9. 3. h. ; 
other^n^ise, patient is improving ; eye-lid very puffy ; stopped arsenic 
entirely, and ordered Phillip's emulsion (opii. morrh.), Fellow's syr. 
a,a, 3j t. i. d., brandy 3ij 9. 2. h. 

March 7. Doing well ; abscess discharging ; stopped brandy ; other 
medicines continued as above ; is able to feed himself ; talks well and 
in all respects quite natural and normal. 

March 12, Sits up ; cannot walk. Ordered zinci sulph. gr. jss t. i. d. 

March ly. Is to-day able to walk down the length of ward. 

March 10, About all traces of the chorea have disappeared. 
Walks, talks, eats and plays around with ease, and is consequently 
considered cured. 

March 22, Is to-day discharged cured, to be watched at office for 
few weeks. 

May I. Patient has been seen weekly since discharge from hospital 
and is completely cured, and in better condition than he has been 
since birth. 



A New Mode of Malarial Poisoning. 

BY J. W. STICKLER, M. D. 

Several months ago I was called to see some children who had been 
ill several days. When I saw them they had slight fever, which the 
parents told me had been intermittent. I afterwards learned that the 
temperature never became much elevated above the normal. There 
was considerable loss of flesh, quite marked anaemia, and restlessness 
at night. Headache and lassitude were prominent symptoms. The 
father told me the children had been in the attic several hours during 
the day — in fact it had been customary for them to play in the attic 
whenever it was inconvenient to have them in the sleeping rooms of 
the second floor. Iwas asked if the tanks near which the children 
played could be a source of danger. When I inspected them I dis- 
covered in and upon the water what appeared to be vegetable matter. 



230 MEDICAL SOCIETY OF NEW JERSEY. 

It was without pronounced odor of a disagreeable kind. I advised 
the mother to clean the tanks, being careful to remove all the foreign 
matter which had collected. She followed my instructions at once, 
and very soon the children were restored to health. I afterwards 
examined microscopically some of the matter*, and found it to consist 
of vegetable and earthy substances, together with many very small 
bodies, round and staff-shaped, which were very active. I a#i rot 
prepared to say that these small bodies were the agents which gave 
rise to the sickness which developed in the children while they played 
near the tanks, but I can say that when they (the tanks) were cleaned 
the disease disappeared. A consideration of these cases seems to 
justify the conclusion that the air of the attic was so affected by the 
contaminated water as to render it capable of producing a compara- 
tively mild form of intermittent fever. 
Orange, May 6th, 1884. 

[To those acquainted with the somewhat inscrutable ways of child- 
ren, it will seem quite probable that the contaminated water not infre- 
quently went directly into those little stomachs, and thus aided in 
producing the symptoms above described.] — Rep. 



Annular Disease of the Ear — a Sequel of Mumps. 

BY DR. T. R. CHAMBERS. 

The insidiousness of the attack and its gravity induced me to note 
the case. 

Master R. H., 16 years old, fair health. Parotiditis began on the 
right side March 17th, reached its height in one week, and had par- 
tially subsided at the end of ten days. March 27, left testicle hot, 
swollen and painful. By April 4th the swelled testicle had resumed 
its natural form again, and patient begins to move around. Accident- 
ally he finds himself deaf in the right ear. 

Examination revealed no pharyngitis ; eustachian tube permeable 
and drum normal. Seen by Dr. Kipp, who tested the patient with 
watch and tuning-forks placed between the teeth on right side of 
the mouth, upon the summit of the cranium and upon the mastoid. 
The right ear fails with all and every test. 



REPORTS OF DISTRICT SOCIETIES. 23 1 

April 30. Absolute deafness continues and, in addition, there is 
slight roaring and rumbling. The left ear is all right. The deafness 
was the first thing noticed, and quite accidentally. There was no 
pain nor other symptom ushering in the serious affection. The roar- 
ing is a later feature. 



The Fallacy of the Legal Tests of Insanity. 

BY p. V. HEWLETT, M. D. 

The consideration of some of the medico-legal views at present 
held regarding insanity, and more particularly its legal tests in criminal 
cases, form the subject to which I would invite your attention in this 
paper. 

It is not my purpose to discuss the pathology of the disease, or 
enter into any examination of the peculiar views which characterize 
it, but simply to consider, in a desultory way, some of the medico- 
legal questions arising from the diverse views on this subject that are 
held by the medical and legal professions. It is a singular thing that, 
notwithstanding the one profession is dependant upon the other, in 
order to arrive at any just conclusions respecting the facts on this sub- 
ject, they both regard the whole" matter from such different and anta- 
gonizing points of view as to retard any attempt to make them keep 
pace with the advance of knowledge on the subject. 

Let us look for a moment at what the tests are, as laid down by the 
law, and their deficiencies as pointed out by the teachings of modern 
psychology. The tests as laid down in the case of McNaughton, who 
was tried in 1843, are conceded by all to represent the law, as recog- 
nized by almost every judicial tribunal. In brief, it reads as follows : 
" Notwithstanding a party commits a wrong while laboring under the 
idea he was redressing a supposed grievance or injury, or under the 
impression of obtaining some public or private benefit, he is liable to 
punishment. The jury ought, in all cases, to be told that every man 
should be considered of sane mind until the contrary was clearly 
proved in evidence ; that, before a plea of insanity should be allowed, 
undoubted evidence ought to be adduced that the accused was of dis- 
eased mind, and that at the time he committed the act he was not 
conscious of right or wrong; Every person was supposed to know 
what the law was, and, therefore, nothing could justify a wrong act, 



232 MEDICAL SOCIETY OF NEW JERSEY. 

except it was clearly proved that the party did not know right from 
wrong ; if that was not satisfactorily proved, the accused was liable 
to punishment. If the delusion under which a person labored were 
only partial, the party accused were equally liable with a person of 
sane mind — if the accused killed another in self-defence he would be 
entitled to an acquittal ; but if the crime were committed for any 
supposed injury, he would then be liable to the punishment awarded 
by the laws to his crime." 

Before I take any exception to this statement of the law, I will 
quote from " Jamieson on Insanity," what I believe to be the true test 
in all cases in which this plea is made the grounds of defense in 
criminal prosecutions : *' Most lunatics," says Dr. Jamieson, *' have an 
abstract knowledge that right is right and wrong is wrong ; but in 
true insanity the voluntary powers to control thought and action, and 
regulate conduct by this standard, is impaired, limited or over-ruled 
by insane motives. A lunatic may have the power of distinguishing 
right from wrong, but he has not the power of choosing right from 
wrong. A criminal is punishable not merely because he has the 
power of distinguishing right from wrong, but because he voluntarily 
does the wrong, having the power to choose the right." 

Here we have a definition of the tests of responsibility in insanity 
which harmonizes with the advance of the sciences of philosophy and 
pathology, as well as the doctrines of modern psychology. 

But, so far as the law and the lawyers are concerned, the science of 
the mind and the knowledge of its disease are as they were a century 
ago. The lawyer is entirely guided by age and precedent ; and while 
he applies the test of reason to the accused, he is wholly uninfluenced 
by it himself. 

" He knows the truth ; he approves it too : 
Condemns the wrong, and yet the wrong pursue." 

He does not act so from any want of intelligence or humanity, but, 
as pointed out by Bentham, ** because he is the slave of precedent." 
In our own courts, and in a recent case, the learned judge, in his 
charge to the jury, said : " The general doctrine of the law is, that in 
criminal cases the test of insanity is, whether the accused was, at the 
time of doing the act, conscious that it was an act which he ought 
not to do. The law does not recognize, as the condition on which 
criminal responsibility shall follow the commission of crime, the pos 
session of one's faculties in full vigor, or a mind unimpaired by dis- 



REPORTS OF DISTRICT SOCIETIES. 233 

ease or infirmity. The mind may be weakened by disease or be 
impaired and have become excitable by a life of intemperance, and 
yet the accused will be criminally responsible for his acts. To estab- 
lish a defense on the grounds of insanity, it must be clearly proved 
that, at the time of committing the act, the accused was laboring 
under such a defect of reason, from a disease of the mind, as not to 
know the nature and quality of the act he was doing, or, if he did 
know it, that he did not know that what he was doing was wrong. 
The accused may have been laboring under an aberration of intellect, 
or he may not have realized the enormity of the crime as fully as he 
ought (I quote expressions used by some of the witnesses) ; and yet 
he may be responsible for his acts. He can only discharge himself 
from responsibility by proving that his intellect was so disordered that 
he did not know the nature and quality of the act he was doing, and 
that it was an act which he ought not to do. If he had sufficient 
intelligence to know what he was doing and that it was wrong, and 
the will and the power to do or not to do it, he is, in contemplation of 
law, responsible for the act he has done." 

The judge in this case lays down the common doctrine of 
insanity as recognized by the law, and framed, not by physicians who 
have a practical knowledge of the insane, but by lawyers. Is not this 
alone a sufficient objection to its inspiring confidence in its soundness, 
if there were no other ? What judge, without a previous training, 
could tell a case of phthisis from one of bronchitis, or give the facts 
upon which the Pathognomonic signs are based } Any medical 
man, reading the lawyer's definition, would know that the definition 
was not that of a scientific body of physicians, having a practical 
knowledge of the insane. 

In the charge which I have just quoted, the judge says that " To 
establish a defense on the grounds of insanity, it must be clearly 
proved that, at the time of committing the act, the accused was labor- 
ing under such a defect of reason, from a disease of the mind, as not 
to know the nature and quality of the act he was doing, or, if he did 
know it, that he did not know that what he was doing was wrong." 
This definition does not take any account of the will, and would 
include involuntary acts, which nobody holds to be crimes. But let 
me ask, What does the law mean by " a defect of reason, from 
a disease of the mind ? " The very words are indicative of the 
date of the patholog)- upon which the definition was formulated. It 



234 MEDICAL SOCIETY OF NEW JERSEY. 

even carries with it so much of its metaphysical associations that if 
one should ask, What is mind ? you would be tempted to answer in 
Hyron's couplet — 

" What is mind ? It's no matter ; 
What is matter ? Never mind." 

Suppose, then, we ask in all seriousness, What is a disease of the 
mind ? some one, perhaps, would answer and say it is a popular and 
comprehensive way of expressing a certain diseased condition of the 
brain. But even this answer would not be at all accurate, for one 
may be of unsound mind and no tests known to science could dis- 
cover any disease of the brain. The truth is, there is no such thing 
as mind, in the sense in which it is used in the law. A man may 
have a defect of memory and yet not be legally of unsound mind. 
When the life of a human being is at stake we should insist on pre- 
cise definitions, and not be misled by popular acceptations, or such 
current expressions as will not bear scientific scrutiny or are not based 
on metaphysics or medicine. 

Intellect is knowing power ; will is controlling power. This dis- 
tinction has been insisted upon by one of the best ethical writers of 
the present century, namely. Professor Henry Calderwood, of the 
llniversity of Edinburgh. '* Will," says this distinguished writer, *• is 
an essential and prominent feature of personality. A person is self- 
conscious, intelligent, capable of self-determination. If intelligence 
is needful to make knowledge of moral law possible ; then will, or 
power of self-detern)ination, is needfull to make obedience to that law 
posiiible ; power of self-determination is thus essential to the nature 
of a moral being. Kant says of man, that his will is his proper self — 
it is the power of control over our whole nature."* 

Thi.s virtually, as you will see, is what Professor Jamison says in his 
lectures on insiinity, but what the law ignores and refuses to 
recogni/e. In the Martin case, the judge, in expounding the 
law to the jury, said : *' The accused may have been laboring 
under an aberration of the intellect, or he may not have realized the 
enormity of the crime as fully as he ought, and yet he may be 
responsible for his acts. He can only discharge himself from respon- 
sibility bv proving that his intellect was so disordered that he did not 
know the nature and quality of the act he was doing, and that it was 



j» (1 



Hund-bookol MouU Philosuphv," pp. lOO and 107. 



REPORTS OF DISTRICT SOCIETIES. 235 

an act which he ought not to do. If he had sufficient intelligence to 
know what he was doing and that it was wrong, and the will and the 
power to do or not to do it, he is, in contemplation of the law, 
responsible for the act he has done. Insanity, in a legal sense, is a 
disease of the mind producing such mental conditions that the 
accused is incapable of distinguishing between right and wrong." 

I have quoted this case because the learned judge has so fully 
adopted and embodied the doctrine recognized by the law, where 
insanity is set up as a defense for crime. Too much importance is 
attached to a knowledge of the nature of the act, while none at all is 
given to a want of will to refrain from it. The law says the accused 
can only discharge himself from responsibility by proving that his 
intellect was so disordered that he did not know the nature of the act 
he was doing, and that it Was an act he ought not to do. This is an 
assumption that it is possible to discover the seat and nature of the 
lesion in insanity. It is not the mind, but the brain that is diseased. 
We might as well talk of a diseased breath in consumption, or a dis- 
eased urine in nephritis. Suppose the mind of the insane person to be 
in the same condition of the body of the choreic patient, would a mere 
knowledge of right and wrong be a test of responsibility } Is the 
choreic patient responsible for the movements of his limbs or the 
muscles of the body, because he knows it is not right for him to do 
it ? Why has he not enough will power to co-ordinate his move- 
ments or to control his grimaces ? we do not know why. But every- 
one must admit that he cannot do so by any exercise of his will ; and 
it would be difficult to find a physician who would have the hardihood 
to go upon the stand and say differently. All that we know is, that 
chorea is a lesion of the nervous system ; but we are unable to deter- 
mine its origin or its seat. And so it is with insanity. It is but a 
symptom of a diseased brain, and science has not yet discovered how 
it impairs or perverts the faculties of the brain. 

Insanity does not affect all alike. In one, the will is impaired ; in 
another, the memory ; in a third, the understanding. This we know 
only from observation ; for pathology has not yet revealed anything 
that would enable us to say in what case the will, the memory, or the 
understanding only was affected. That insanity is a symptom of a 
lesion of the cortical substance of the brain, is generally agreed ; and 
when we can say with as much certainty what the nature of the lesion 
is as we can where it is — or as we can when the white substance is 



236 MEDICAL SOCIETY OF NEW JERSEY, 

the seat of the disease — it will be time enough to dogmatize on the 
knowledge of right and wrong being a true criterion of the doctrine 
of responsibility as a legal test of insanity. 

The plea of insanity is now so often urged as a defence in criminal 
trials — not only abroad and in other States, but in oUr own courts — 
that it behooves us to take into consideration the subject in its rela- 
tions to us as medical men. Nothing can be more unsatisfactory than 
the present state of the law in its relations to insanity, or its legal 
tests regarding responsibility and their antagonism to all the known 
laws of a scientific pathology. The conflict appearing to be between 
old judicial decisions, taken as precedents, and modern psychological 
medicine. That the law bases its claims to right upon age and pre- 
cedents rather than on facts made known by the advance of science, 
will hardly be disputed by any who is at all familiar with the history 
of the cases as they have appeared in the courts from the beginning 
of this century to the present day. Let us look for a moment at the 
law as it stood at that time. Then, for the first time, was recognized 
the necessity of taking into account any minor degrees of insanity less 
than furious madness as an excuse for crime. Previous to that, as 
Justice Tracy expressed it, the plea was only permitted "where a 
person does not know what he is doing, no more than a brute or wild 
beast." 

The next enlightenment which the public mind received through 
juristic expression was at Hadfield's trial in 1800, when Erskine first 
announced that delusions— where no raving madness existed — were 
the true character of insanity implying irresponsibility. The most 
important case in the history of this question was that of Bellingham, 
who was executed in 181 2. It was here that Lord Chief Justice 
Mansfield announced, that " if a person laboring under mental 
derangement were capable, in other respects, of distinguishing right 
from wrong, he could not be excused for any act of atrocity which he 
might commit. It must be proved beyond all doubt that, at the time 
he committed the atrocious act, he did not consider that murder was 
a crime against the laws of God and man." 

But in 1843 we find the most authoritative statement of the law, in 
the McNaughton trial, where the accused was acquitted on Chief 
Justice Tindall's direction — that the point for the jury to consider 
was whether, at the time the act was committed, the accused had that 
competent use of his understanding as that he knew he was doing 



REPORTS OF DISTRICT SOCIETIES. 237 

wrong by the very act, itself a wicked and wrong thing. The annun- 
ciation of this doctrine at that time produced so much consternation 
and was regarded as so urgent, that the House of Lords ordered a 
series of questions to be laid before the* fifteen judges, in order to 
settle the law. In answer to these questions it was, in substance, laid 
down, " That to entitle an accused to acquittal on th& grounds of 
insanity, it is necessary that he be of diseased mind, and, at the time 
he committed the act, not conscious of right and wrong, or that he 
be under some delusion which made him regard the act as right." 
Though many attempts have been made to correct or alter this law, 
Sebald says . *' The statement of the fifteen judges after the Mc 
Naughton case, remains the chief exposition of the English law 
where insanity is pleaded in excuse for crime." 

This, then, is the law as it relates to the legal tests, or, at least, so 
much of it as includes its real error and shows its untrust- 
worthiness ; for the object of any investigation is to arrive at the 
truth not by crude means only, but by all means known and recog- 
nized to science and observation ; and, as we know, the knowledge of 
right and wrong has no significance, even in diagnosing mental 
derangements, any theory of irresponsibility built thereon must be 
untrustworthy as evidence. Dr. Blandford says : " No more curious 
test of insanity was ever invented — none which more plainly shows 
the utler ignorance of the subject prevailing among those who have 
no acquaintance with the insane " ; and his ideas are so often repeated 
by almost every writer on mental diseases, that innumerable opinions 
could be cited. The simple proposition expounds itself, and needs no 
refutation for those having any practical knowledge of the insane. 

Dr. Ray says : " Statutes were formed and principles laid down 
regulating the legal relations of the insane long before physicians had 
obtained any accurate notions respecting this malady, and, as might 
naturally be expected, error and injustice have been committed to an 
incalculable extent under the sacred name of law. In addition to the 
obstacles to the progress of knowledge in other diseased conditions, 
insanity, but a few years ago, was looked upon or considered as 
resulting from a direct exercise of divine power, and not from the 
operations of the ordinary laws of nature ; and, being thus associated 
with mysterious and supernatural phenomena, confessedly above our 
comprehension. Inquiry has been discouraged at the very threshold 
by the fear of presumption or, at least, the apparent fruitlessness of 
the labor." 



238 MEDICAL SOCIETY OF NEW JERSEY. 

e mysterious and supernatural associations of insanity, as well as 
^eir effect upon the judiciary of the time, are well exemplified by 
l^r« Maudsley, who says: "The law is simply doing now, in 
rtigard to insanity, what it did formerly in regard to witchcraft--giving 
erroneous opinions on matters of fact to the jury under the name of 
aw, and wi^h all the weight of judicial authority. In one case of the 
atest trials for witchcraft in this country (England), Lord Hale, whose 
^ue data concerning insanity were so long acted upon in ouf courts 
justice, instructed the jury : ' That there are such creatures as 
witches, he made no doubt at all. For, first, the scriptures had 
artirnf^ed so much ; secondly, the wisdom of all nations had provided 
aws against such persons, which is an argument of their confidence 
Oi such a crime.' " The jury accordingly found a verdict of guilty ; 
the judge, satisfied with it, condemned the»persons to death and they 
Were executed. It is one of the last executions for witchcraft in 
England, for it occurred at that time— and this should never 
be forgotten — when the belief in witchcraft was condemned by the 
enlightened opinion of the country. As it was then with witchcraft, 
so It is now with insanity — the judge instructs the jury wrongly on 
the matters of fact ; they find, accordingly, a verdict of guilty ; he is 
satisfied with the verdict, and an insane person is executed. 

Prior to the. present century, there was nothing that could be called 
a science of mental pathology. The facts then known were of the 
crudest kind. Groups of symptoms, in accordance with the nosologi- 
cal system of the day, constituted insanity. As an example of this, 
one eminent authority (Willis, 1822,) divides the consideration of the 
causes and treatment of the whole subject of all mental derange- 
ments into two classes — the high state and the low state. The mor- 
bid anatomy was but little known, and a proper study of the 

• 

phenomena of the disease was obstructed, in a measure, by the 
popular ideas of the supernatural origin of insanity, rather than its 
being a part of a physical cause and depending on the usual 
laws of physical disease. Clinical observation, based on a more cor- 
rect diagnosis and pathology, has since demonstrated that artificial 
nosological groups of symptoms bear no relation whatever to the 
pathological lesions which they were formerly supposed to indicate, 
and has led to a mass of information connected with insanity which, 
up to this time, has never been correctly systematized. 
Again, more recent hystological research shows us that insanity is 



REPORTS OF DISTRICT SOCIETIES. 239 

but a collection of symptoms, the result of a pathological lesion of 
the gray substance of the brain, and that it is not indicated, in its 
seat or condition, by any special symptoms or functions, or charac- 
terized by the exaltation of one function while the others remain 
unimpaired. It is governed by the same laws that determine the 
physiological and pathological conditions of any other organ of the 
body, and follows the rule that impaired or perverted function denotes 
abnormal conditions of the organ. Why, then, should we expect to 
find any elaborate test for insanity founded on a pathology that was 
so exceedingly crude ? Nor do we. We cannot but admit that what 
appears to be a crude and imperfect law was the best that could be 
moulded upon such a crude and imperfect knowledge of the disease 
for which the law was formed. Our ancestors had a definite idea of 
what ^Aey meant by a mad man ; and the law had no choice but to 
apply a coarse test to a crude material. 

The advance of science, however, by showing that insanity was but 
a symptom of a disease of the brain, and that the corresponding per- 
versions of the faculties of intellect and will were dependent upon a 
settled pathological lesion — even though we may not state just what 
it is — has entirely overthrown the errors that our forefathers labored 
under, and we are led to see the fallacy of their positions. It is true 
that these advancements have been slowly wrought ; but it is equally 
true that they are now unquestionably acknowledged by all who have 
any experience in the treatment of this disease. 

It is to the pioneers in this field that we look with such admiration. 
To such eminent and hard-working men as Haslam, and Pinnel, ancj 
Hallaran, and Tuke, and Esquirol, and Spurzheim, and Georget, and 
Connelly, and Prichard, and so I might name a dozen more in the 
same chronological order, who have striven so hard and so earnestly 
to advance and demonstrate the practical tiuth of psychological 
medicine, and to whose labors is due that advance which it has so 
steadfastly made. It is not that the law as it was was not as applica- 
ble as could be made with existent state of knowledge, but it is that 
the law still remains as crude as it was originally, and blindly adheres 
for right to its age and precedents, rather than to any facts known to 
advanced science. Since Hadfield's trial, in 1800, many attempts 
have been made to modify the test so as to make it the more in 
harmony with existing facts. But they are still deficient in the most 
essential particulars. All the essential elements of the tests, from a 



240 MEDICAL SOCIETY OF NEW JERSEY. 

legal point of view, are based upon the facts of an impairment of 
intelligence, or as they put it, the consciousness of right and wrong 
and a knowledge of the consequences of the act, while the teachings 
of physiology, pathology and psychology all point to the volition as 
the most potent factor as a test for responsibility. It is not, as we 
have -already said, whether the lunatic possesses the knowledge of 
right, but whether he had the power or will to do the right. It is 
power, not knowledge, that is the potent factor in irresponsibility. As 
Jamieson puts it, a lunatic may have the power of distinguishing right 
from wrong, but he has not the power of choosing right from wrong. 
A criminal is punishable not merely because he has the power of 
distinguishing right from wrong, but because he voluntarily does the 
wrong having the power to choose the right. Most reputable writers 
on medical jurisprudence acknowledge that' the real criterion of 
responsibility is the freedom of will, or the power of the individual to 
control his actions. This has been more or less advocated by 
Esquirol, Marc, Ray, Pagat, Jamieson, Nuttmaier and Maudsley. 
Ray says : " Liberty of will and action is absolutely essential to 
criminal responsibility." Pagat observes : " Loss of control over our 
actions which insanity implies, is that which renders the act undeserv- 
ing of punishment." Dr. Taylor : " The power which is most defi- 
cient in the insane is the controling power of the will." Dr. Bucknill 
says : " Responsibility depends upon power, not knowledge ; still less 
upon feeling." 

Dr. Forbes Winslow, in speaking of the defense of insanity, says : 
V When such questions have come before the judicial tribunals, the 
presiding judge, in his charge to the jury, has invariably referred to 
the dicta of preceding administrators of the law and quoted their 
definition or description as an unerring test of the presence of mental 
derangement in any case in which the malady is said to exist." How 
absurd, upon reflection, must such a course of procedure be. Has 
not our knowledge of disorders of the mind advanced in the last fifty 
years .^ Do we not know more of insanity than our professional 
brethren did who lived in the days of Coke, Mansfield and Erksine ? 
If so, how ridiculous it is to cite their opinions, or to bind us down 
to the authority of men whose information on this subject must, of 
necessity, have been extremely limited and circumscribed. " The 
knowledge obtained by men of a subject which they have grappled 
with all their lives," says Chief Justice Gibbon, " ought surely to pre- 



REPORTS OF DISTRICT SOCIETIES. 24 1 

vail against knowledge gleaned from the horn books of a profession 
to which the gleaners did not belong."* 

The falseness of the legal position will appear at once, if we sup- 
pose a case of poisoning instead of a case of mental derangement. 
What would be thought of a judge who, when medical evidence of 
poisoning was given, should instruct the jury, as a principal of law 
they must be governed in their verdict by the presence or absence of 
a particular symptom ? Judge Dix says : " If the tests of insanity are 
matters of law, the practice of allowing medical experts to testify 
what they are should be discontinued. If they are matters of fact 
the judge should no longer testify without being sworn as a witness, 
and showing himself qualified to testify as an expert ; but, in truth, 
the tests of insanity are no more matters of law than are the tests of 
a poison or the symptoms of disease. "f In Boardman vs, Wordman, 
it was said if a jury were instructed that certain manifestations were 
symptoms or tests of consumption, cholera, congestion or poison, a 
verdict rendered in accordance with such instructions would be set 
aside, not because they were not correct, but because the question of 
their correctness was one of fact to be determined by the jury upon 
evidence. 

The foregoing considerations then lead us to the inference that 
there are no legal or medical tests based upon a knowledge 
of right and wrong that the true criterion of irresponsibility 
appears to be in the possession of certain powers of the will, 
rather than of the intelligence ; the power of controlling an act — 
of doing, rather than knowing —appearing to imply the existence 
of a state of cerebration that carries with it responsibility. A test 
somewhat similar to this is applied by juries under the directions of 
judges, to distinguish murder from manslaughter ; and sanity and 
homicidal mania are not more nicely blended than those shades of 
guilt whereby manslaughter passes into murder. And I cannot resist 
the conclusion that the principles of law which led to the formulation 
of the present tests, were based on such error of fact as to render 
them fallacious as tests and untrustworthy as evidence. I think that 
it has been further shown that in recent times our success in the 



* Smith vs. Cramer, Am. Law Register, 353. Maudsley's Resp. Mental Dis- 
eases. 

t State vs. Pike. - 

16 



242 MEDICAL SOCIETY OF NEW JERSEY. 

treatment of insanity has been just in the proportion as we have 
abandoned obsolete theories of " mind diseases " and built up a new 
superstructure, based upon the foundation of an improved patho- 
logical knowledge. This great improvement in our practice appears 
to be attributable, first, to the greater accuracy with which we can 
now detect the morbid conditions which pervert or destroy the normal 
functions of cerebration ; and second, to our better acquaintance with 
their physiological and psychological laws. How often, during the 
last thirty or forty years, have we been asked : Of what use is your 
microscopes, your chemical analyses, and your other implements of 
research ? And, in reply, we point to the revolution that has gone on 
in the practice of our profession during that time; and, of which 
progress, none has been more steadfast and unquestionable than that 
relating to the brain and the nervous system. We point with a 
deserving and just pride to the establishment of scientific laws instead 
of empirical rules, and to the abandonment of a palliative in favor of a 
curative treatment. 

If, then, such great improvement in our practice can be made by 
reason of this scientific advancement, cannot a similar progress be 
made in regard to our legal test in insanity, in determining which we 
are so intimately concerned with the legal profession ? Such enlight- 
enment can only come through the medical men who, throughout 
their own life, are constantly in active association with the investi- 
gators of such subjects. The two professions, the legal and the 
medical, have often to deal with the same subjects, though from 
differerft points of view — the one looking at the pathological state as 
a condition to be treated for relief, the other interested only in so far 
as it affects the safety of the individual in his legal relations. Any 
knowledge in the possession of the lawyer must, of necessity, be 
derived from the physician. And it would greatly promote the 
advancement of this much-to be-desired end if the medical man, in 
his relations to the law as witness or expert, was so qualified on this 
subject and guarded in his statements as to present only the most 
unquestionable facts for the consideration of the law. As Dr. 
Bucknill remarks : " That, notwithstanding this divergence of view 
from which the two professions regard insanity, it appears that this 
antagonism of opinion in individual cases and for specific purposes is 
unnecessary and dangerous. The physician ought to aid the judge, 
the judge ought to accept the aid of the physician to the utmost of 



REPORTS OF DISTRICT SOCIETIES. 243 

his knowledge and ability, within his proper sphere, the judge being the 
authoritative exponent of the law, the physician acting as witness — 
being its important but casual instrument ; he being called upon to rec- 
ognize, by his special knowledge, that kind and degree of insanity to 
which immunity from punishment is attached." All that the medical 
expert can do when called upon to give information is to look out well 
and carefully for all the evidence of disease capable of impairing the 
acts of volition, as well as intelligence, and having once discovered 
them, honestly and fearlessly advance them, irrespective of how such 
opinions will affect the individual case in view. This is a matter for 
the law,.and medical men should leave it where it belongs. We must 
remember that both law and medicine are concerned in the solution 
of this most important problem — the law deaHng with the applicability 
of the statutes, and medicine, with the structures and functions of the 
human body ; and if the structures and functions of man, and the 
physical and mental derangements to which he is subject, are the 
objects of the study and practice of his professional life, the exper- 
ienced physician must be the best exponent of its psychological 
phenomena. 

Here we can scarcely refrain from stating our conviction that 
an unnecessary retardation of the perfections of the law is dependent 
upon the antagonism of the legal and medical professions, regarding 
the point of view from which its investigations are made, and that the 
aims of both— which is a determination of actual facts— would be 
materially assisted by a renovation of the methods used at the present 
time in ascertaining those facts. If duly-qualified medical men were 
employed by the court as recognized exponents of the scientific facts 
before them, to assist the court in arriving at just conclusions, instead 
of leaving the medical expert to the procurement of interested 
counsel, a long step would be taken towards this desired end ; for 
counsel who are endeavoring to obtain a conviction or discharge of 
an accused, often labor so zealously to confound or confuse the 
medical witness, or to obtain from him only such portions of his 
conclusions as suits the ends they have in view, that he is prevented 
from giving the impartial conclusions of his science as a whole, and 
this of necessity must distort the medical facts in the case, as pre- 
sented to an unscientific jury. This energetic zeal on the part of 
counsel may be correct in law, as a part of their duty, and 
deserving of the warmest praise as such, but it can scarcely be 



244 MEDICAL SOCIETY OF NEW JERSEY. 

expected to harmonize any of the conflicting opinions on this subject 
between the two professions. 

In view, then, of these existing relations of law and medicine on 
the subject of insanity, let me say that I endorse that portion of the 
report of the section on medical jurisprudence drawn up by C. S. 
Garrison, Esq., and published in the last Transactions of our State 
Medical Society, in which he says : " An expert should not come into 
court with any preconceived theory favorable to one or the other 
parties litigant ; he should neither break down or bolster up the case 
as made by the material facts ; he should make no attempt to influence 
the jury as to the facts of the case, nor of the application of )iis par- 
ticular line of testimony to those facts. What he should do, is to 
state and inform the mind of the judge and jury with the truths and 
conclusions of his science as are pertinent to the facts in controversy, 
or as affording criteria by which the true bearing of material facts 
may be ascertained. The law of science is the fact within the knowl- 
edge of the expert which, in his testimony, he is to deliver. The 
practical results of this view, if it were adopted by medical specialists, 
would be to raise their science from the domain of discordant facts, 
to one of accepted law ; that, as the judge charges the jury what for 
the purposes of the case in hand they shall take as the law judicial, 
so would they, in the same manner, take from the medical expert the 
law scientific. All invitation to charlatanism and advocacy would be 
removed, and experts, instead of unseemingly jostling with each other 
in the witness-box, would take their seat, as it were, beside the court, 
assuming, for the time, almost judicial ermine. Then medical 
science, so long forced to act the part of a paid trumpet in our courts, 
would unite with the science of jurisprudence in the due administra- 
tion of justice and the law of the land." 

An eminent writer on medical jurisprudence has very properly 
stated that physicians have no right to interfere with the administra- 
tion of the law, which is the judge's function ; nor is it their duty to 
decide what is necesssary for the welfare of the State, that being the 
Legislature's work. Their concern is with the individual. But 
they plainly have the right to declare that the nature of a 
crime involves two elements : first, the knowledge of its being 
an act contrary to law, and secondly, the will to do or forbear doing 
it, and to point out that there are some insane persons who, having 
the former, are deprived, by their disease, of the latter— who may 



REPORTS OF DISTRICT SOCIETIES. 245 

know an act to be unlawful, but may be impelled to do it by a convic- 
tion or an impulse which they have notihe will or the power to resist. 
Recognizing the obvious difference between him who will not and 
him who can not fulfill the claims of the law, it is their function to 
point out the conditions of disease which constitute incapacity ; and 
when they find a false fact solemnly annunciated as a rule of law, to 
bring forward into all the prominence they can, the contradictory 
instances which their observation makes known to them. 

Once more, to quote Judge Doe : " That cannot be a fact in law 
which is not ^ fact in science ; that cannot be health in law which is 
disease in fact " ; and it is unfortunate that courts should maintain a 
contest with science and the laws of nature upon a question of fact 
which is within the province of science and outside the domain of law. 
If it is necessary that the law should entertain a single medical opinion 
concerning a single disease, it is not necessary that that opinion 
should be the cast-off theory of physicians of a former generation. 



Gloucester county. 

To the Chairman of the Standing Committee^ &c. : 

The health of Gloucester County during the past year 
has been somewhat better than during the two preceding 
years. Nowhere in the county have there been any 
malignant epidemics, and the mortality from acute 
diseases has been quite low indeed. There have occurred 
many deaths among the aged from natural causes, aided 
by slight attacks of various complaints. 

During the summer months there was the usual 
amount of cholera morbus and diarrhoea, but dysentery 
was seen in only a few cases. Cholera infantum is not 
much seen in this vicinity. Those cases which are met 
with are usually contracted somewhere else. 

The fall and winter months were characterized by 
nothing of especial note. There were the usual number 



246 MEDICAL SOCIETY OF NEW JERSEY. 

of lung troubles, but no epidemic of pneumonia, pleurisy, 
or chest diseases of any kind. With spring occurred a 
general epidemic of ulcerated sore-throat, pervading the 
whole county with about the same severity. By fnr, the 
greater number of cases were mild, those affected more 
severely were characterized by prominent febrile symp- 
toms. Sequelae were very rare indeed, those which occurred 
being usually abscess of throat. All the cases fully 
recovered. A treatment adapted to local inflammations 
generally was the one usually employed. The average 
length of sickness was about a week. There have 
occurred quite a number of cases of scarlet fever in the 
district. All, with very few exceptions, have been mild 
in type and simple in form. In Mantua a few cases of 
malignant scarlatina occurred. All proved fatal. Malaria 
in all its varied forms we have with us at all seasons of 
the year. It complicates everything ; the very young 
and the very aged, the woman in child-birth and the 
surgical case, the clean and the unclean all suffer more or 
less from its effects. The sine qua non of a physician's 
armory for the past three years has been quinine or its 
less potent substitutes, cinchonidia and cinchona. Arsen- 
ious acid, iron, etc., all came in use, but cannot be relied 
upon for sure results. 

Glassboro has had nothing unusual in the way of 
epidemics. There have occurred sporadic cases of the 
various fevers and inflammations, but of a mild type and 
ending in recovery. Clayton has been visited by no 
serious epidemics. Dr. Fisler reports cases of mumps, 
measles, tonsillitis, and a few cases of scarlet fever. Dr. 
Buckingham reports the same, with several cases of an 
eruptive fever resembling scarlatina, but differing in 
something, as they contracted scarlatina afterward. Dr. 
Trenchard reports cases of malignant scarlet fever in 



REPORTS OF DISTRICT SOCIETIES. 247 

Mantua, all ending fatally. Also, two cases of true 
croup, ending in recovery. He used inhalations of the 
vapor of slacking lime, quinine and iron internally, with 
hot applications externally. Dr. Halsey, Jr., reports 
mumps and a few cases of scarlet fever at Williamstown. 
Dr. Phillips has had measles and mumps at Hurflfville. 
During the spring, ulcerated sore-throat. Harrisonville 
has had no epidemic excepting tonsillitis. Dr. Stanger 
reports a case of true croup, ending fatally in three days. 
Dr. Allen reports no epidemics. Dr. Ashcraft reports 
scarlet fever, adult cases in excess. Dr. Laws has seen 
scarlatina in a mild form, ulcerated sore-throat and a 
number of cases of swelling of the glands of the neck. 
"Malaria with us always." Dr. Oliphant sends me a 
report of an epidemic of scarlet fever and ulcerated sore- 
throat occurring in Bridgeport. Reports also a case of 
true croup, ending in recovery. The use of the vapor 
of slacking lime was followed by the expulsion of the 
false membrane from the larynx. Internal treatment 
of iron, quinine and potass, chlor. Dr. Halsey, Sr., 
reports epidemic of ulcerated sore-throat, and scattering 
cases of scarlatina simplex. I have seen a few cases of 
scarlatina simplex and have had the same experience 
with the epidemic of ulcerated tonsils, etc., that all the 
other physicians of the county have experienced. Mala- 
ria has given me much trouble as a complication all 
through the year. When the cause per se of disease, it 
has been quite easily combated, but when existing as 
a complication it seems more difficult to manage. 

BENJAMIN F. BUZBY, M. D., Reporter. 



248 medical societv of new jersey. 

Epidemic of Scarlatina. 

BY E. T. OLIPHANT, M. D. 

This epidemic began January 2d, 1884, seemingly with two isolated 
cases, but which I afterwards found to be a full-fledged epidemic, 
numbering in all ninety-three cases, treated by myself, and am happy 
to say all recovered. Two-thirds of the cases were anginose in char- 
acter ; the others, simple. 

TREATMENT. 

Scarlatina simple. — First saw that the bowels were well evacuated ; 
if fever ran high, gave tr. aconite folia, spts. ether nit., and plenty of 
hot lemonade to keep up the action of the kidneys. For the sore 
throat, potassium chlorate. 

Anginose variety, — If the bowels were constipated, gave a brisk 
cathartic, followed by tr. ferri. chloride and chlorate of potassium, 
internally. If considerable febrile action, quinia sulph. and hyd. chlor. 
miti.. according to age and amount of fever, flanked, as it were, by 
hot drinks (as lemonade), and putting the patient to bed immediately. 
If the throat was exceedingly ulcerated, I used tr. ferri. chlor. and 
chlorate of potassium, strong, as a gargle ; and if this did not seem 
to be satisfactory, I used argenti nitratis grs. xxx, ad. f. f i of distilled 
water, and also permanganate of potassa. J'or the irritation of the 
skin, lard or sweet oil. The diet, as a rule, was liquid, but not low by 
any means — beef tea, mutton broth, with rice and plenty of milk. 
But I invariably gave quinia sulph. for a tonic until I discharged them, 
and no solid food, such as meats, until desquamation had entirely 
ceased. 

Following the latter part of this epidemic, came follicular tonsilitis, 
with diphtheritic exudation. Treated on general principles ; no fatal 
cases. 

I also had several cases of pneumonia and inflammatory rheuma- 
tism. 

The causation of this epidemic of scarlatina I have not fathomed 
to my satisfaction, but we had plenty of material for it to prey upon. 
We w^ere partially surrounded by low meadow lands, and at that time 
very wet weather, with variations of temperature, and water in most 
of the cellars of the neighborhood. 

Bridgeport, N. J. 



REPORTS OF DISTRICT SOCIETIES, 249 

HUDSON COUNTY. 

To the Chairman of the Standing Committee^ &c. : 

« 
The County of Hudson has, during the past year, been 

remarkable for its general increase in healthfulness and its 

much-reduced death-rate. We feel proud in showing a 

record so much better than that of former years. 

The reasons can be traced to various causes and to' 
changed conditions. Quite a large part of the cities of 
Jersey City and Hoboken (where the bulk of the popula- 
tion of the county resides) is built on low ground, much 
of which has been filled in to raise it above tide-water, 
and, even at its present elevation, is little above high- 
water-mark. This condition would naturally be imagined 
to be a foundation for much sickness and suffering, and 
yet no great proportion of our sickness can properly be 
attributed to it, and these local conditions probably will 
eventually be so improved as to become only a minor 
factor in the production of disease. This low condition 
may be even beneficial, in proportion as the size and 
number of our sewers are increased, from the fact that 
the rise and fall of the tide will constantly, and in a more 
or less thorough manner, cleanse and scour out such low- 
lying sewers, wherever it can reach and have full play on 
them. This is a great boon to a city so situated that 
sufficient fall cannot be had to carry away the impurities, 
and where, at the same time, the water supply is limited. 
In towns up the Hudson — such as Newburg, Poughkeep- 
sie and Hudson — a very great fall from head to outlet is 
probably an iqiprovement, but, with our low and level 
grounds, the tide performs a health-giving function. 

We have, among other things, the much-dreaded sewer 
gas to contend with from our sewers ; and this the tide 
does much to carry away. But if all water-closets and 



250 MEDICAL SOCIETY OF NEW JERSEY. 

waste-pipes had traps in the streets where the connection 
is made with the sewer, and these had some method of 
ventilation — and if foul-air pipes were carried to the tops 
of all houses, I think we would get rid of most of the 
sewer-gas, which so often seems to be the direct cause of 
many of our diseases. 

The cool summer of the past year had much, also, to 
do with our low rate of mortality, by reducing the num- 
ber of cases of diarrhoea and cholera infantum, which are 
usually so prevalent during hot weather, especially among 
bottle-fed babies. 

In Hoboken there was a change in the water supply, it 
being taken from the Hackensack instead of the Passaic 
river as formerly. This is universally supposed to be one 
great cause of the increase in our healthfulness. It is to 
be hoped that the water supply of all cities may be made 
as pure as possible, for this purity of water certainly goes 
far towards giving good heal.th. It is to be hoped, also, 
that our chemists will find out a substitute for mothers* 
milk in cities, for hitherto, to arrange to bring up feeble 
children on the bottle, was like giving them a burial cer- 
tificate. Many are working on this important desidera- 
tum, and it is to be hoped that their works, together with 
future experience of all kinds, will develop some food 
which will very nearly take the place of mothers* milk, 
and stop the enormous death-rate among bottle-fed babies 
that has existed in past years, and so largely increases the 
death-rate of all cities. 

The high mortality rate of Hudson County may be 
partly explained by the large number of deaths which 
occur from accidents and injuries. All the great railroads 
of the State have their termini within this county, and to 
meet them are miles of shipping along the water. These 
necessarily imply multitudes of tracks, switches, bulk- 



REPORTS OF DISTRICT SOCIETIES. 25 1 

heads and wharves, with thousands of men employed in 
the duties of transportation, and exposed to the accom- 
panying dangers. Among this class of the population, 
accidents are frequent and injuries severe, and fatal 
results consequently are numerous. These circumstances 
must be taken into consideration in making any compari- 
son between the mortality of this and other inland 
counties. 

Still another cause of the increased death-rate in cities 
is found in the so-called and, of late, much-discussed 
puerperal fever. It does seem as if this, like cholera 
infantum, ought to be dropped from the list of fatal 
maladies ; but, on the contrary, it is fast becoming a bug- 
bear and a perfect dread to our pregnant women. The 
discussions which point to so many unnatural proceedings 
during and after confinement, only tend to produce fear 
in what should be looked upon by all women as a natural 
and safe phase of nature. It would seem, from the pre- 
cepts of some of our learned teachers, that nature is not 
to be depended upon, and that the all-wise Creator did 
not create aright, and that man must step in and rearrange 
much. • The sooner this untenable idea is dropped or 
disproved, the better it will be for our lying-in patients. 
Let nature take its course ; and let us dispense with all 
internal washes, and throw the modern bed-pan to the 
dogs. The upright posture for urinating, with external 
cleansing, will perform the work required. The physi- 
cian, however, must see that he himself is perfectly 
innocuous, and conveys no poison in his person or his 
clothing. 

Dr. Taylor, of Union Hill, reports that ** The health of 
this place has been comparatively good during the past 
year. Measles, diphtheria and scarlet fever have appeared 
for a short time, and in so many cases as to be almost 



252 MEDICAL SOCIETY OF NEW JERSEY. 

called epidemic. Sanitary laws are, to a great extent, 
disregarded, garbage, slops and refuse from the houses 
being commonly thrown into the streets and allowed to 
decompose. The soil extends but a few feet below the 
surface, and then the rock of which the whole hill is 
formed stops further descent. As there is no system of 
sewerage or drainage here, all the products of decomposi- 
tion, the contents of the water-closets and the street filth, 
percolate through the soil down the rock and there 
remain, I say remain, but should add that almost every 
house has a well, and at least ow*' family uses the water of 
each well for drinking, culinary and domestic purposes. 
Moreover, there are few cellars but what have in them 
constantly from one to three or more feet of water. 
This gives rise to almost every variety of malarial disease, 
and to pulmonary diseases as well. Several cases of 
typhoid fever appeared last autumn, but care was taken 
and the disease was prevented from spreading. Since the 
introduction of the Hackensack water into the town, the 
rate of disease and also of death has become remarkably 
less ; and now this water is becoming popular among 
many who formerly used wells. A sewer is beihg built 
in one of the streets, and in time the system will be 
extended over the whole town.' 

G. F. PITTS. Reporter. 



HUNTERDON COUNTY. 
To the Chairman of the 



During the year end 
the people of Hunterdc 
good. Yet in almost ( 
vailed. With but a fe 



REPORTS OF DISTRICT SOCIETIES. 253 

a mild type and amenable to treatment. The malarial 
fevers have been less in number than they have been for 
the same length of time for several years past. Typhoid 
fever has rarely occurred. Colitis has scarcely appeared. 
Vernal influenza has been general, and in some localities, 
of grave types. 

Dr. W. R. Little, of Bloomsbury, reports as follows: 
" Parotitis began about the middle of January, of mild 
type aud prevailed extensively. A malignant form of 
scarlatina appeared in the Muscanetcong valley about the 
first of March, causing some deaths. About the same 
time began an epidemic of malignant diphtheria. There 
has been about the average amount of lung diseases, but 
less than the average of malarial fevers. During the 
year I have met an unusual number of cases of' cancer, 
and I doubt whether this disease occurs as extensively 
outside of the Muscanetcong valley as within it." 

Drs. Schenck and Ewing inform me that in Fleming- 
ton and vicinity there has been about the usual amount 
of sickness. Severe cases of pneumonia have been of 
frequent occurrence. There has been more than the 
average number of phthisis pulmonalis. Parotitis has 
been epidemic. Bronchitis has been general and of a 
severe type. 

Drs. G. H. Larison and N. B. Oliphant inform me that 
the health of Lambertville and vicinity has been good. 
There have been less malarial fevers, less diphtheria and 
scarlet fever; but few cases of typhoid fever and but few 
of pneumonia. Measles and parotitis have been epi- 
demic; both being mild. An unusual number of cases 



254 MEDICAL SOCIETY OF NEW JERSEY. 

phthisis, much colitis in September, and many cases of 
vernal influenza in March and April. 

Dr. N. B. Boileau, of Perryville, reports that during 
February and March, acute bronchitis of a typhoid type 
prevailed as an epidemic. During the winter there were 
many cases of obstinate laryngitis. In March and 
April, vernal influenza, wide-spread and obstinate in 
character, prevailed. He reports many cases of rheu- 
matism and more than the average of sciatica. 

Dr. J. S. Cramer, of Sergeantsville, reports less malaria 
during the past year than usual. Diphtheria has been of 
rare occurrence. Many cases of paralysis have been seen. 
During October, typhoid fever prevailed to a large extent. 
Vernal influenza began in January and extended through 
February, March and April, Measles and pneumonia 
were prevalent in March and April, and during the spring 
many cases of jaundice occurred among children. 

Dr. Best, of Rosemont, reports that there has been 
about the usual number of cases of malarial fever. 
Phthisis and apoplexy have been more frequent than 
usual. Diarrhoea prevailed during the summer and 
autumn. Parotitis and pertussis were epidemic during 
March and April. 

Dr. Shanon, of Stanton, reports about the average 
amount of sickness in this district. Varicella appeared in 
May. Typhoid fever of a severe type prevailed in 
August. During November and December, measles 
prevailed. During the winter months, pertussis, often 
complicated with pneumonia, occurred. 

Dr. Night reports about the average amount of sick- 
ness. A mild form of scarlatina occurred in ^ 
February and March. During the same moT 
were several cases of diphtheria. Rheur 
occurred more frequently than usual. 



REPORTS OF DISTRICT SOCIETIES. 255 

Dr. Levitte, of Baptistown, reports that there has been 
more than the usual amount of sickness in that locahty. 
Pneumonia, severe scarlatina, neuralgia and rheumatism 
have prevailed extensively. In my own practice, nothing 
unusual has occured. There has been about the usual 
amount of sickness. During the winter and spring, 
measles were prevalent. Vernal influenza began in Feb- 
ruary and continued until April. Diseases of the nervous 
system have been numerous. Scrofula is increasing. 
Cases of rheumatism have been very numerous. 

The notes of a case read before the Hunterdon County 
District Medical Society by Dr. H. Shannon, I append 
entire. 

C. W. LARISON. Reporter. 

RiNGOES, N. J., May ist, 1884. 



BY H. SHANNON, M. D. 

Ovulation without menstruation ; conception ; albuminuria ; dropsy. 
Delivery at full term ; good getting up. 

Mrs. S., ffit. 21. Was called to see the above case during the spring 
of 1882. Founil the patient a bright, active lady, suffering from 
malarial trouble, which had resisted active treatment for some months. 
Her mother gave me a history of the case, viz. : Since she was 16 
years of age has had leucorrhoea, but has never menstruated, I 



256 MEDICAL SOCIETY OF NEW JERSEY. 

abdomen enormously enlarged, and, on examining the urine, found it 
highly albuminous. I suggested the idea of conception, but she 
thought that impossible, as she had never menstruated and had never 
been able to have free intercourse with her husband, nor had she felt 
any signs of life. Brisk hydragogue purgatives and diuretics were 
ordered and continued, with relief of all the symptoms save the 
albumen, which remained, but in less quantity. She was then put 
upon tr. ierri. chl., with bitter infusions. After the effusion had dis- 
appeared, the gravid uterus could be distinctly felt and seen, with 
the foetal head lying high up in the fundus. 

On the 1 2th of September I delivered her of a nine-pound child, 
being a breach presentation ; otherwise, a perfectly normal labor, and 
with a good getting-up. The mother never felt any motion of the 
child, never having menstruated ; and the inability to have free inter- 
course on account of the irritability of the vagina, led her to believe 
that conception was impossible. 

Stanton, N. J. 



MERCER COUNTY. 
To the Chairman of the Standing Committee^ &c. : 

The County of Mercer, during the past year, has been 
unusually healthy, as far as your reporter can ascertain. 
During the summer months there were fewer cases of 
intestinal troubles of infants and children, though dysen- 
tery among adults prevailed to a greater extent in Tren- 
ton than for many years before. The cases reported at 
the meetings of the District Society were, as a rule, 
severe, and in many cases proved fatal from complications, 
such as hemorrhage, etc. One oase of small-pox occurred 
in Trenton during the year, but the prompt and efficient 
action of the authorities stamped the disease out before 
another case occurred. 

During the fall and winter months, about the usual 
amount of pneumonia and catarrhal affections were en- 



countered by the p 
perhaps, below the a 

Rubeola prevailed 
Chambersburg duriii] 
spring, some of the 
rhal bronchitis and a 

We have also had 
vailed pretty general 
males affected, orch 
some instances the 
enlargement of the 
Among the females, 
. Pertussis has prev; 
be said to have b« 
majority of cases, w; 
the usual number of 
diseases have occurre 

Diphtheria and sc< 
form of sporadic ca 
year, though no epi 
cases have been unu 
instances. 

Malarial diseases '. 
past few weeks, thar 
have occurred durin 
many instances, show 
gestion, and other m 
type. 

Dr. W. W. L. Phill 
uria occurring as a 
treated the case du 
unable to say whetht 
of chlorate of potassi 
Dr. Phillips also writt 



258 MEDICAL SOCIETY OF NEW JERSEY. 

fact that scarlet fever may occur more than once in the 
same individual, yet it probably seldom happens that the 
same observer meets with the disease in the same person 
a second time. This, however, has been his experience 
in the case of Mrs. S., aged 27 years, who, during the 
past winter, has had an attack of genuine scarlet fever of 
the anglnose variety, the Doctor having treated her when 
she was eight years of age with an attack of the same 
kind, which was so well marked and severe as not to 
admit of any mistake. 

Dr. R. M. Rankin, of Hopewell, reports the health of 
his section good, no epidemics having prevailed excepting 
an annual return of diphtheria, which was quite severe 
and fatal in the early part of 1883, but which entirely 
disappeared after the unusual amount of snow and rain- 
fall of the beginning of 1884. 

Dr. Rankin reports a case of puerperal convulsions, in 
which the patient, after having had twenty-five convul- 
sions and remaining in a comatose condition for forty- 
eight hours, made a slow but complete recovery. The 
treatment consisted in instrumental delivery, hypoder- 
mic injections of morphia and atropia, and bloodlett- 
ing. Ether was used during delivery, which required 
unusual force. The child weighed ten pounds, and was 

dead. 

The Dispensary, which was noted in the report of 1883, 

still continues to do a good work. About fifteen hundred 

patients have received treatment- during the past year. 

A number of gynaecological cases have been operated 

upon, and many other cases of special interest have be 

under observation of the staff during the y 

It is with great pleasure and satisfa 

reporter can state that death has not en 

during the past year. 



REPORTS OF DISTRICT SOCIETIES. 259 

The meetings of the Society are more largely attended, 
and greater harmony prevails among the members, since 
ethical subjects and disputes have given place to the 
more profitable discussions of medical subjects and 
reports of interesting cases. We have few sympathizers 
with the " new code " movement, though a few express 
themselves in favorable terms of its adoption. 

In regard to the question, '* Has your Society taken 
any action on the recommendations in report of com- 
mittee at the last meeting in regard to the curriculum of 
medical study? " I would merely say that as the report of 
the committee was simply received and referred to Com- 
mittee on Publication at the last meeting of the State 
Society, and will come up at the next meeting for final 
action, our Society, deeming any action of theirs 
premature, has not taken any action in regard to the 
matter. 

H. M. WEEKS, Reporter. 
Trenton, May 14th, 1884. 



MIDDLESEX COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

During the past year epidemic diseases have not been 
so prevalent as during th6 preceding year. Malarial dis- 
eases have prevailed in* Woodbridge, Perth Amboy and 
South Amboy, but not to so great an extent as in former 
years. In New Brunswick, certain localities seem to be 
affected more than others. The residents on the out- 
skirts of the city and in localities where it is low and 
moist suffer most. The disease was principally of the 
intermittent type, and readily amenable to treatment. 



26o MEDICAL SOCIETY OF NEW JERSEY. 

Scarlatina has occurred sporadically. The cases were 
quite mild and free from complications. 

Diphtheria has prevailed to a great extent. During 
the months of November and December an epidemic of 
this disease occurred in New Brunswick, causing a con- 
siderable number of deaths. Some of the patients died 
from the direct effect of the poison on the nerve centres, 
others from septicaemia, while a large number died from 
laryngeal complications. Since that time a few cases 
have been present in New Brunswick, but were of a 
rather mild character. 

Rubeola has scarcely been known in New Brunswick, 
but in Washington, South River and Sayresville an 
epidemic occurred during the months of January and 
February, several deaths occurring from complications, 
principally pulmonary. 

Typhoid fever has been seen in New Brunswick, but the 
number of cases were not many, and only a few deaths 
occurred from this disease. During the winter months, 
pneumonia and pleurisy were common, but neither dis- 
ease was of a severe type. Cholera infantum and dysen- 
entery were not so common as during the preceding year. 

Dr. C. H. Andrus, of Metuchen, reports as follows : 
'* The past year has been one of unusually good health in 
Raritan township. No epidemics have prievailed. Mala- 
rial diseases have been less prevalent than during any 
period of the last ten or twelve years. In July and 
August, dysentery of a somewhat severe character 
occurred in a few localities. During the winter months, 
more cases of pneumonitis occurred than was usual. for 
the season, but they were rarely fatal, except among 
those quite aged. Diphtheria and scarlatina have scarcely 
been known among us during this last year. Even the 
record of births shows quite a falling off in the depart- 



I 



REPORTS OF DISTRICT SOCIETIES. 261 

ment of obstetrics — a fact fully realized by the doctors 
also." 

Dr. Wm. V. Wilson, of Dayton, reports as follows : 
" For the past year the general health of the township of 
South Brunswick was good. The past two years have 
brought many sporadic cases of cerebro-spinal meningitis, 
none in my practice having proved fatal. The disease 
manifests itself alone or as a complication of some other 
diseases. Adults and children were alike affected. The 
question arises as to its cause. To my mind it is the 
result of a specific kind of malaria, over which the 
bromides exert a control ; and 1 also believe that the 
malaria producing remittent fever is of different kind from 
that producing intermittent fever, inasmuch as quinia 
often fails in. the former, while the gelseminum speedily 
effects a cure. Gelseminum is worthless in simple chills 
and fever. One of the peculiarities of cerebro-spinal 
meningitis is the inflammation of the bowels and lungs, 
or acute gastritis and vomiting. These diseases are more 
apparent than real, in a large percentage of cases being 
relieved by bromides and quinia, without morphia or any 
other treatment, unless the pain is severe. In the past 
winter and spring occurred an epidemic of mumps. In a 
considerable number of cases there were some complica 
tions of spinal, but chiefly of cerebral meningitis, requir- 
ing large doses of bromides. Next in frequency, in the 
male, was orchitis ; and in the female, swelling of one of 
the mammae. During the winter there were many cases 
of pneumonia of a mild type, no deaths resulting there- 
from. Our township, owing to its good water, has been 
free from typhoid fever. There was no perceptible 
increase of malarial diseases. The census has been well 
added to. At the present time a disease called the winter 
cholera prevails upon Little Rocky Hill. Its attack is 



262 MEDICAL SOCIETY OF NEW JERSEY. 

sudden, and the disease spreads rapidly through the 
families it attacks. The diarrhoea is watery and the 
dejections frequent ; occasionally there is much pain in 
the bowels. The treatment is quinia, with bismuth and 
opium. The disease had existed there before in the 
spring of the year, and is due to some peculiarity of the 
water supply, which is largely surface water in the wells.** 
The reporter is pleased to note that no death has 
occurred among the members of the County Society. 

FRANK M. DONOHUE, Reporter, 



MONMOUTH COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

Previous to receiving your circular, a request had been 
sent to each member of the County Society of- about the 
same import, to which requests but three answers were 
received. Being on the northern edge of the county, it 
is rather difficult for your reporter to make an accurate 
report without the co-operation of brother physicians in 
other parts of the county. 

The past year has been probably more than usually a 
healthy one throughout the county. Excepting measles, 
which has been pretty general, no epidemics have pre- 
vailed. Diseases of respiratory organs have been less 
severe. Malarial diseases have been less common and 
generally more easy of control. Typhoid fever prevailed 
in different parts of the county during the autumn of 

1883. 

Dr. Long, of Freehold, says that city has been remark- 
ably free from all epidemic and endemic diseases. A few 
cases of measles have appeared, the first for twelve years. 



REPORTS OF DISTRICT SOCIETIES. 263 

He states that catarrhal diseases and pneumonias have 
prevailed to less extent, and that the mortality was less 
than in previous years. 

Dr. Thompson says that Ocean Beach, during the past 
year, has been visited by no epidemics. One case of 
scarlatina maligna occurred, but by strict quarantine an 
epidemic was prevented. Malarial diseases are not known 
at the Beach, excepting by imported cases. One case of 
typhoid fever occurred during the autumn, and several 
others at the same time at Shoreville, about' half a mile 
distant. Intestinal troubles were very mild during the 
summer, no deaths occurring among the children. Dr. 
Thompson states that among a summer population of 
5,000 and a winter population of 400, since May ist, 1878, 
to the present time, only three deaths have occurred 
among children. Twenty-five is the total number of 
deaths at Ocean Beach for the same time. He reports 
that skin diseases have been more prevalent than usual, 
and since March ist, a number of cases of acute rheuma- 
tism have occurred, and promptly yielded to ol. gaulthe- 
ria and alkalies. He sends notes of a case of Bright's 
disease, as unusual for the passage of blood coagula only, 
in the first stage, and the sudden appearance and disap- 
pearance of albumen in the urine. 

Dr. Arrowsmith, of Keyport, reports having met about 
the same diseases and in nearly the same proportions, 
excepting malaria, which is less prevalent and more easily 
controlled than in previous years. He referred to the 
summer complaints of children as being mild during the 
last summer. In the autumn he met with a number of 
cases of typhoid fever. 

Dr. Welch, of Keyport, states that he has met with less 
of malarial diseases and diseases traceable to or compli- 
cated with malaria than for five years past. A number of 



A 



264 MEDICAL SOCIETY OF NEW JERSEY. 

cases of typhoid fever occurred in his practice during the 
months of July, August, September and October, three 
of which were accompanied with extremely grave symp- 
toms. In one, septicaemia began on the twenty-first day, 
announced by a sharp chill, followed by temperature of 
105^ and renewal of the typhoid phenomena, and the 
formation of abscesses in different parts of the body. 
Other cases were mild in character, two being " walking 
cases,'* the temperature following pretty accurately the 
thermometric observations of Wunderlich — proceeding in 
regular stages of weekly and half-weekly periods. In 
four cases, copious perspiration at night, without diminu- 
tion of temperature, occurred about the fourteenth day 
of the disease, and continued until convalescence was 
fully established. 

Dr. Welch says : " In but one case did I notice an 
eruption on the skin," and continues : '* I am convinced 
that this is to be found less in country than in city prac- 
tice, though even in the latter it is by no means the rule. 
Of 5,988 cases occurring in the London Fever Hospital 
during twenty-three years, as stated by Wilson, the 
eruption was absent in 1,382. Murchison gives statistics 
of ages when the eruption may be wanting; Jenner 
found it less frequent in children ; Flint states that the 
proportion of cases in which it occurs varies in different 
years. He found it absent in twenty-four cases out of 
seventy-three which he has recorded, though carefully 
looked for. Trousseau says the eruption has never been 
observed in any epidemic in Louraine, while Raele 
believes anti-phlogistic treatment at the outset prevents 
the development of the eruption, for which reason, he 
avers, it is rarely met with in the wards of La Charity. 
Dr. John Harley has made dissections of cases where all 
the ulcerative intestinal conditions characteristic of the 



REPORTS OF DISTRICT SOCIETIES. 265 

disease were found, no eruption having occurred in life.** 
In speaking of treatment, Dr. Welch says : ** In my 
experience I have often observed the happiest effect from 
large doses of digitalis in these fevers, small doses being 
perfectly futile, while large doses, to the extent of a tea- 
spoonful (tincture), -have calmed delirium and induced 
refreshing slumber, reducing the pulse and, to some 
extent, the temperature, though I have never observed 
the fall of 2^ or 3^ spoken of by Aitken. I invariably 
use it in severe cases, commencing the dose at from ten 
to twenty drops, and gradually increasing to thirty or 
forty, and more if needed, the remedy suspended when 
prudence dictates, though the effect to be continued 
needs repetition of the medicine in six hours, usually. 
I have never met with the cumulative effect spoken of by 
writers on therapeutics, and my use of it in fevers, cardiac 
diseases, and two cases of delirium tremens which I have 
recorded, where doses of one-half ounce were used, has 
given me abundant opportunity to study the effects of 
the drug. The instances of poisonous effects on animals, 
given in Stills, must be looked upon as deliberate 
attempts on healthy organizations, and the distinction 
between that and the action of digitalis when appropriate 
to a disease must be taken into account when speculating 
on probable result's. My experience with quinine in 
typhoid fever leads me to almost condemn its use in large 
doses. If it reduces the temperature it is for only a very 
limited time, and it never abridges the duration of the 
disease. It does not prevent the sepsis which causes 
relapses ; so what is gained ? " 

Dr. Welch remarks a less number of diarrhoeal diseases 
among infants than for many years past. He also refers 
to the slow advance of an epidemic of measles, which 
occurred at Port Monmouth, seven miles distant, in the 



266 MEDICAL SOCIETY OF NEW JERSEY. 

spring of 1883. The epidemic, after slowly radiating from 

family to family, reached this town during the past 

winter, where the contagion has shown the same tardy 

influence, and is still slowly extending. Many of these 

cases have been complicated with severe bronchitis. As 

a notable instance of this disease being exceptionally 

dangerous when grafted upon a previously-existing one, 

he refers to a case of a little girl of two years who passed 

through virulent types of scarlatina and diphtheria in 

February and March of last year, only to die on the third 

day of an attack of measles, in June following. 

A number of interesting cases given by Dr. Welch, and 

one by Dr. Thompson, I give in full. 

D. E. ROBERTS, Reporter, 
Keyport, May 7th, 1884. 



Cases. 



BY GEO. T. WELCH, M. D. 



Persistence of the Diphtheria Contagium'—Y omv members of a 
family named Voorhees were attacked with diphtheria in January, 
1883. Of these, three were attacked with a virulent form of the dis- 
ease, one, an infant, dying in a short time ; two suffered from para- 
plegia for weeks afterward. After convalescence gradually merged 
into complete recovery, the house was scrubbed and whitewashed 
within, and underclothes and bedding washed, and carpets and cloth- 
ing aired in blustering winds then prevailing. On or about March 
1st, a brother of Mrs. V. came from Jamesburg to visit her. The 
disease had not prevailed in that village. On the 5th he was attacked 
with a mild form of the diphtheria, and was ill for several days. On 
April I St the family moved into another house, about a mile distant. 
J. P., a young man of 30, who occasionally visited the family, on Sun- 
day, August 26th, remained all night, sleeping on a bed occupied by 



REPORTS OF DISTRICT SOCIETIES. 267 

the brother mentioned. On August 29th he was attacked with diph- 
theria in a malignant form, accompanied with severe hemorrhages 
from the throat on September ist, but recovered. 

Diagnosis of Pregnancy. Case /. — In October, 1882, I called to 
see Mrs. J. W., who believed herself to be suffering from an abdom- 
inal tumor. She was strongly impressed with the belief that she had 
passed the menopause about a year before, being 48 years of age, and 
the menses having made but scanty and fitful appearance since she 
was 46. She had lost all date of the last period. After an external 
examination of the abdomen with manipulation of an ovoid, moveable 
tumor, the vaginal speculum was used, when all that portion of the 
uterus to be seen was found to be of an intensely purple appearance. 
Recalling the fact of this phenomenon being looked upon by some 
gynecologist as diagnostic of pregnancy, I suggested the explanation 
to the patient, who appeared offended, but was willing to await a 
further development. The delivery of a female child occurred about 
four months afterward. 

Case II. — In May, 1883, I was called to see Mrs. Van B., who was 
very much depressed with the idea that she had an ovarian tumor. 
There was a remarkable appearance of the abdomen, as though it 
contained a multilocular tumor. Examined with a speculum, the 
cervix-uteri was found to be of a purple color. The patient was very 
incredulous of the diagnosis I ventured to niake, but was delivered 
on September 12th of a female child. 

Hemorrhage during' last stages of Cirrhosis of the Liver. — Mrs. 
J. L., aged — , who died of cirrhosis of the liver on the 30th of May, 
1883, had copious hemorrhages from the stomach and bowels on 
April 13th and i6th, and on May 27th and 29th. The blood expelled 
from the stomach was in vermiform coagulae, from six to twelve inches 
in length, and half an inch in diameter. The appearance of four of 
these in a small vessel after vomiting was remarkable in the extreme. 

Poisoning from eating young leaves of Cat-Brier, or Smilax 
Rotundi folia. — June 7th, 1883, 1 was called to see a colored boy, aged 
five years, who was suffering with intense pain in the bowels, with a 
pulse quick, jerking, 120 to the minute; the skin cool; countenance 
lethargic. Unable to learn anything further than, that he had been 
in good health up to four hours previous. I prescribed an anodyne, to 
be repeated as necessary, and expected to hear a favorable report, but 



268 MEDICAL SOCIETY OF NEW JERSEY. 

did not, at my next visit. During the succeeding days until death on 
the fifth day, the above symptoms continued, with nausea and consti- 
pation. The bowels were moved by enemata containing castor oil. 
Opiates only quieted pain ; alcohol excited it ; quinine appeared to 
give the most ease. The child died about 6 P. M., and at the autopsy 
made at lo P. M., I was assisted by Dr. D. E. Roberts. The stomach 
and small intestines were very white, inflated with gas, and specked 
with a green substance, which was found to be vegetable stems. The 
colon was intensely conjested, coiled like a crimson serpent. Blood 
had been freely emitted from it into the pelvic cavity. Cutting into 
the colon it was found to be filled with a dark-green pulp. Examined 
under the microscope, stems of leaves and vegetable cells were found 
in abundance. 

It was ascertained from the children of the family that, on the 
morning of the 7th, he had gathered his hat-crown full of the young 
buds and tender leaves of the cat-brier, and had, with great persever- 
ance, eaten them all. 

Retarded Labor. — On December 21st, 1883, I delivered, with the 
forceps, Mrs. E. P. of a male child. The date of the last day of her 
last menstrual period was February 15th, counting from which, the 
period of utero-gestation would have been 308 days. The child was 
enormous, cephalotripsy having been found necessary before it could 
be delivered. . 



Bright's Disease. 

BY CHAS. H. THOMPSON, M. D. 

Geo. A r, aged 16 years, was cleaning out a pond at the High- 
lands, N. J., on May 19th, 1883. 

May 2 1 St. Having a feeling of soreness and general distress, he 
consulted a physician, who prescribed for him and advised him to 
return home. 

May 22d. Came to the office complaining of headache, general dis- 
tress and diarrhoea. Tongue slightly coated, pulse normal, and pass- 
ing about the usual quantity of urine. Thinking he had taken cold, I 
prescribed therefore. 

May 23d. Called at the office again, saying he was no better, and 
enumerated the following symptoms in addition to those previously 



REPORTS OF DISTRICT SOCIETIES. 269 

• 

reported, viz. : great thirst, loss of appetite, pain over the whole 
abdomen, entire suppression of urine, and has passed a number of 
small cylindrical coagula. Passed catheter, and found the bladder 
empty. Diagnosed Bright's disease, and prescribed hyoscyamus to 
relieve pain, and poultices of digitalis leaves to the back and abdomen. 

May 24th, 9 A. M. Called and found patient in the following condi- 
tion : Pulse, 120; temperature, ioii° ; tongue, heavily coated ; nau- 
sea ; no appetite ; puffiness of the entire body ; pain over the whole 
abdomen, especially severe in the left hypochondriac region ; slight 
distress in the back over the kidneys, and constipation. Has passed 
about 5i of blood, and several coagula, two lines in diameter and two 
or three inches in length, but no urine. Passed the catheter, and 
again found the bladder empty. To continue the hyoscyamus, and 
the poultices after dry cupping the back. Gave elaterium in divided 
doses until the bowels are moved. 

9 P. M. Patient in about the same condition as at the morning 
visit. Bowels have been very freely opened. Again applied the cups, 
and continued previous treatment. 

May 25th, 9 A. M. Pulse, 120; temperature, 102° ; distress over the 
left kidney more severe ; ankles very much swollen ; other symptoms 
the same as yesterday. Has passed about ^ij of blood and several 
coagula, but no urine. Applied wet cups (drawing about ^vi of 
blood), and continued previous treatment. 

9 P. M. Condition much the same. Has passed one very long 
coagula and ^iss of port- wine urme. Half of this urine coagulated 
on the addition of heat and nitric acid. On account of extreme rest- 
lessness, gave Dover's powders to-night. 

May 26ih, 9 A. M. Pulse, 102; temperature,- iooi°; pain over 
abdomen still continues ; no distress over kidneys, and other symp- 
toms about the same. Has passed quite ^viii port-wine urine, which 
contained a large percentage of albumen. Again applied dry cups. 
To continue the poultices, and gave a diuretic mixture. 

May 27th, 9 A. M. Pulse, 90 ; temperature, 99° ; tongue cleaning ; 
appetite returning ; no distress over kidneys ; pain over abdomen 
almost gone. Has passed fully four quarts of urine, entirely free from 
albumen, during the past twenty-four hours. 

May 28th. Pulse normal ; temperature normal ; tongue clean, and 
rapidly convalescing. Put the patient on ammon. hydrochlorate and 
tr. ferri. chlorid. three times a day. The diet was almost exclusively 
milk with lime water. 



270 MEDICAL SOCIETY OF NEW JERSEY. 

On June loth George was able to call at my office. I examined the 
urine twice a week, but found no albumen. The pain did not 
entirely disappear from the left hypochondrium, but he improved 
steadily until June 21st, when he had severe frontal headache. 

June 22d. Was summoned in haste at 4 A. M. to see George, and 
found the following condition of affairs ; About 3.30 A. M. he had a 
violent uraemic convulsion on awakening from sleep. Just as I 
arrived he had a second one of great violence, which lasted fully 
twenty minutes. After the convulsion passed I found : the pulse 
120; one pupil dilated, the other contracted ; anaesthetic cornea; the 
whole body slightly puffed ; urine albumenous, and that he had had 
no suppression previous to the convulsion. Gave elaterium gr. i J, in 
four powders, one every hour until bowels moved, digitalis poultices 
to back and over the abdomen, and potassii bromid grs. xx every 
hour. 

10 A. M. Pulse, 120; temperature not taken, but was not high; 
comatose ; slightly stertorous breathing, and has had seven more con- 
vulsions. 

2.30 P. M. Dr. Johnson met me in consultation. Pulse, 130; pupils 
dilated and not responsive to light ; incontinence of urine ; very rest- 
less ; bowels still constipated, and has had twelve convulsions. No 
urine could be obtained for examination. To continue the poultices 
to give potassii bromid grs. xx every half hour, and to give enema at 
once. 

8 P. M. Pulse, 1 30 ; skin intensely hot ; convulsions less frequent, 
and very much weaker. 

June 23d. Much better. Pulse, 120; temperature, 101°; no con- 
vulsions since 9 P. M. ; coma not so deep ; pupils normal, and 
responsive to light ; head, face and tongue very much swollen, and 
has passed "^vi of urine free from albumen. He again began to 
improve very rapidly, and on June 27th was able to be about the 
house. On the morning of the 29th he was found dead in bed. He 
retired the previous night feeling quite restored and cheerful. 



REPORTS OF DISTRICT SOCIETIES. 2/1 

MORRIS COUNTY. 

To the Chairman of the Standing Committee, &c. : 

Reports have been sent to me by Drs. Barker, Owen 
and Flagler, of Morristown ; Dr. Stiger, of Mendham ; 
Dr. Farrow, of Middle Valley ; Dr. Pennington, of Bask- 
ingridge ; Dr. Condict, of Dover ; Dr. Wiggins, of Suc- 
casunna, and Dr. Day, of Bloomingdale. From these 
reports it is evident that the year now closing has been 
an unusually healthy one. 

MALARIAL DISEASES. 

About the average number of cases. Dr. Farrow notes 
a large number of intermittent neuralgias. 

ALIMENTARY CANAL. 

No severe epidemics. 

AIR PASSAGES. 

Pneumonia, so prevalent in Madison and Morristown 
at date of our last report, has given these places but 
little trouble, but is reported more prevalent in Basking- 
ridge and Mendham. 

SCARLATINA AND DIPHTHERIA. 

Nowhere epidemic in a severe form, except at Mend- 
ham and Baskingridge. At Morristown and Middle 
Valley, epidemics are reported, so mild and irregular in 
type as to make the diagnosis rather doubtful in the 
majority of cases. 

MEASLES. 

Bloomingdale reports an epidemic ; also, of whooping- 
cough. 

TYPHOID FEVER. 

Very few cases, indeed, reported. 

Dr. Barker reports a case of " pneumonia accompanied 
in the early period by great cardiac depression. During 



2/2 MEDICAL SOCIETY OF NEW JERSEY. 

the first week the thermometer in the axilla ranged 
between xoi^ and I03i^. In the mouth it could not be 
raised above 97^^. After the patient began to improve, 
the buccal temperature gradually approached that in the 
axilla, and finally corresponded with the latter very 
closely/' 

Dr. Condict reports a case of hydrocele radically cured 
by the method of Prof. R. J. Levis. The Doctor, after 
evacuating the fluid with a trocar and canula, and while 
the canula was still in situ, injected into the cavity of the 
sac one fluid drachm of liquified carbolic acid. The 
canula was removed, and the scrotum freely manipulated 
with thumb and finger to diffuse the carbolic acid oyer 
every part of the sac. Smarting was complained of for 
only two or three minutes, and was succeeded by a sense 
of numbness. The patient did not lie down on account 
of the operation, and the next day performed his ordinary 
labor. The cure was complete without the loss of time. 

Your reporter regrets to announce the death of Dr. 

John M. Cuyler, U. S. A., an Honorary Member of this 

Society. 

STEPHEN PIERSON. Reporter, 



OCEAN COUNTY. 
To the Chairman of the Standing Committee, &c, : 

MEASLES 

were epidemic throughout the county, generally of a mild 
type. 

MUMPS 

were prevalent in some sections. 



REPORTS OF DISTRICT SOCIETIES. 273 

DIPHTHERIA. 

Only a few sporadic cases, except in Cedar Run, where 
Dr. Hilliard tells me there was an endemic of a mild 
character. 

TYPHOID FEVER. 

We have had less typhoid fever than during any of the 
three previous years. 

SCARLET FEVER. 

A few sporadic cases. 

DISEASES OF THE AIR- PASSAGES. 

Pneumonia and bronchitis were quite prevalent. Of 
the former, a few cases were very severe. Less influenza 
than is common. There were many deaths during the 
year from phthisis. 

WHOOPING-COUGH. 

A few sporadic cases only. 

TETANUS. 

Two cases occurred, both of which proved fatal. 

The committee appointed to examine the copies of 

diplomas filed in the County Clerk's Office attended to 

that duty, and found one individual practising without a 

diploma. 

E. C. DISBROW, Reporter. 

Toms River, June ist, 1884. 



PASSAIC COUNTY. 
To the Chairmaii of the Standing Committee^ &€, : 

The following report upon the diseases which have pre- 
vailed in our county during the past year is based upon 
the communications received from a number of physicians 
who reside and practice in this city, no report having been 

18 



2/4 MEDICAL SOCIETY OF NEW JERSEY. 

received from the City of Passaic, or any other locality in 
this county. 

The estimated population of Paterson is sixty thousand, 
a fact which must be kept in view while considering the 
prevalence of any disease which may be expressed below 
in figures. 

MALARIAL DISEASES. 

The various forms of malarial fever have prevailed dur- 
ing the past year to a somewhat less extent than usual. 
The intermittent forms were met with in the quotidian, 
tertian and quartan varieties, but the tertian was proba- 
bly the most common. 

Diseases of a neuralgic and inflammatory nature have 
shown a disposition to intermit, but the tendency for such 
affections to complicate with malaria has been less 
m'arked than in former years. 

Some of the physicians reporting have met with a good 
deal of remittent fever, which was characterized by very 
high temperatures. 

There have been no cases of pernicious or congestive 
fever reported. 

DISEASES OF THE ALIMENTARY CANAL. 

Diarrhcea, dysentery, cholera morbus and cholera in- 
fantum prevailed to a less extent than for many years. It 
will be remembered that the summer of 1883 was except- 
ionally cool. This exemplifies a fact which is generally 
conceded — that, as a rule, the prolonged high tempera- 
tures of this climate greatly increase the tendency to the 
intestinal fluxes. 

Dr, Rogers, and others, report the occurrence of a few 
cases of dysentery in the winter and early spring. Your 
reporter met with two genuine cases of dysentery in 



REPORTS OF DISTRICT SOCIETIES. 275 

January, which resisted, with remarkable obstinacy, the 
treatment employed. 

DISEASES OF THE AIR PASSAGES. 

Pneumonia seems to have been met with more fre- 
quently than usual. In December and January there 
were many cases, severe in type and often proving fatal. 
Bronchitis, severe in character, was very common during 
the winter. 

CONTAGIOUS AND INFECTIOUS DISEASES. 

Cases of typhoid fever have occurred throughout the 
year, but there has probably been rather less of this dis- 
ease than in either of the two years just preceding. Dr. 
Newton, Health Inspector of this city, in his communica- 
tion to your reporter, refers to two cases of this disease 
which were directly traceable to the use of polluted water 
from a private well located in the rear of the house where 
the disease occurred. The Doctor expresses the opinion 
that the public wells in this city, upon which so many 
rely for drinking water, are probably the cause of many 
cases of continued fever. There were twenty-one deaths 
from this disease in Paterson from May ist, 1883, to April 
30th, 1884, distributed as follows : 

May. 1883 2 deaths. 

August, ** 2 ** 

September, " 6 " 

October, " 2 

November, ** 2 

December, *' 2 

February, 1884 r 

March, ** 2 " 

April, ** 2 " 



c< 

a 



276 MEDICAL SOCIETY OF NEW JERSEY. 

Physicians in attendance upon typhoid cases are not 
required to report the existence of this disease to the 
Board of Health, so there is no means of knowing the 
actual number of cases. 

There were comparatively few cases of puerperal fever 
during the year. 

It is generally believed that there have been fewer 
cases of diphtheria than usual. There were reported to 
the Board of Health one hundred and thirteen cases, 
with thirty-six deaths, distributed as follows : 

May, 1883 8 cases reported, o deaths. 

June, " ^ o " " o " 

July, " I " " I 

August, " 6 " " 2 

September, ** 10 " " 4 

October, " 9 *' ** 5 

November, " 12 *' *' 6 " 

December, *' 15 ** " 6 

January, 1884 24 " " 6 

February, *' 8 ** " 2 

March, '' 11 ** '' 3 

April, " 9 '' '' o 



n 



t( 



i( 



(( 



<( 



(( 



Total 113 36* 

Percentage of deaths to cases, 31.86 per cent. 

Health Inspector Newton expresses the opinion that 
not more than two per cent, of the cases of diphtheria were 
concealed from the health authorities by reason of non- 
report from attending physicians. 

Cases of scarlet fever were reported from various parts 
of the city throughout the year. It has generally been 
mild in type. Its prevalence is referred to in the com- 



REPORTS OF DISTRICT SOCIETIES. 



27; 



munication of one physician as epidemic in character. 
There were reported to the Board of Health five hundred 
and six cases of this disease, with sixty-nine deaths, dis- 
tributed as follow : 



1883 .... 48 cases reported, 8 deaths. 



May, 
.June, 

July. 

August, 

September, " 

October, 

November, 

December, 

January, 1884 

February, 

March, 

April, 



it 



a 



n 



n 



ic 



n 



n 



n 



li 



26 " 


30 " 


••••34 " 


.... 45 " 


... 41 " 


....69 " 


73 " 


.... 58 " 


22 " 


....45 " 


....IS " 



a 



n 





10 






4 






7 






6 






9 






7 






4 






5 






3 






2 





Total 506 



69 



Percentage of deaths to cases, 13.63 per cent. 

An epidemic of measles, severe in type, prevailed in 
this city during the winter and spring. The disease was 
very often complicated with pneumonia and severe bron- 
chitis. There were fifteen deaths reported, which were 
distributed as follows : 



October, 1883 i death. 

December, " 2 deaths. 

January, 1884 8 

March, ** 3 

April, •* I 



a 



n 



n 



Total 15 



278 MEDICAL SOCIETY OF NEW JERSEY. 

Dr. Newton, to whom I am indebted for the statistical 
part of this report, considers that measles has been the 
primary cause of death in a number of cases reported as 
having died from bronchitis and pneumonia. 

There have been no cases of variola since April, 1883. 

PHILANDER A. HARRIS, Reporter. 



SALEM COUNTY. 

To the Chairman of the Standing Committee, &c, : 

Perhaps our county has not, during the present year, 
had more than the usual amount of sickness, this spring 
proving quite a contrast as compared with that of last 
year. In general character the troubles of the year have 
been those that usually attend the several seasons. Mala- 
ria generally plays an important part in our practice, and 
has the past year proved no exception as an element re- 
quiring medical attention. Still, the number of remittent 
and intermittent fever cases have not been so large as in 
the year preceding, when in frequency of occurrence and 
recurrence it might have been considered epidemic. Paro- 
titis and measles have been almost universally epidemic. 
A great many cases have occurred in our city, and I find 
the physicians of the county have met with these affec- 
tions very often. 

Measles seem to attack those who thought they enjoyed 
a perfect immunity — having had the disease previously. 
Yet this did not seem to prove a safeguard, as those hav- 
ing it before were again attacked, a case occurring in my 
own practice having had this year measles for the third 
time. 

In several of the cases of mumps, occurring more 



REPORTS OF DISTRICT SOCIETIES. 279 

particularly in the male than female, there has been con- 
siderable trouble caused by the metastatic tendency of the 
affection, the testicle becoming considerably enlarged and 
inflamed, causing not a little anxiety to the patient, one 
case, in whom the complication proved most alarming, 
atrophy of the testicle following the subsidence of acute 
symptoms. 

Very few cases of diphtheria and scarlet fever. Articu- 
lar rheumatism has been quite prevalent, a number of the 
cases being among children. 

As regards alimentary affections, they have not pre- 
vailed to an unusual extent during the year. This might 
be considered the more remarkable, as the increased use 
of water for drinking purposes supplied by the waterworks, 
and its impurity in the summer months, would tend to 
increase bowel troubles. 

Although this water is obtained from a pond with mud 
bottom, is decidedly discolored, and from smell would be 
supposed to contain more or less decaying vegetable mat- 
ter, yet, even with its frequent use last summer for all 
purposes, no sickness was ascribed to this source, and 
throughout the year we can find no trouble that points 
its origin to this as a contaminating medium. 

The mortality among children has been less this year 
than the one previous, and in the summer season fewer 
cases of cholera infantum and allied diseases have occurred 
among them. 

CLIFF. M. SHENON, Reporter. 

May, 1884. 



28o MEDICAL SOCIETY OF NEW JERSEY. 

SOMERSET COUNTY. 

To the Chairman of the Standing Committee^ &c. : 

Our county has been free from any alarming epidemics. 

I have but little to report beyond the usual routine of 

practice, not having received any communications from 

outside members ; and this being so, conclude they have 

nothing special to send me. 

W. B. RIBBLE, Reporter. 
East Millstone, May 14th, 1884. 



SUSSEX COUNTY. 

To the Chairman of the Standing Committee^ &c, : 

I have been enabled to gather from intelligent 
citizens from the different quarters of the county, 
that the year has been a very healthy one ; that there 
have been no epidemics of any account, and less than the 
usual amount of disease arising from malaria. 

Dr. J. L. Allen, of Lafayette, in a few lines states that 
he has not knowtfi so healthy a season in forty years. 

Dr. John Miller, of Andover, reports that in his prac- 
tice (a district nearly always laden with malaria) there has 
been much less than the average amount of sickness. In 
the autumn there were a few cases of cerebro-spinal men- 
ingitis, following a mild form of remittent fever. Three 
out of the number were fatal. One of the characteristics 
of the malady was permanent contraction of the muscles 
of the right side of the body, the head being drawn and 
fixed at an angle with the spinal column, and, in the fatal 
cases, remaining in that position, paralysis and death soon 
following. It is to be regretted that the Doctor did not 
furnish a detailed history of one or two cases, and more 



REPORTS OF DISTRICT SOCIETIES. 28 1 

particulars in regard to the number of cases, age, sex, per 
cent, of recoveries, etc. 

The Doctor also reports a case of senile gangrene, 
which may be of interest. The patient was a male, 80 
years of age. On his first visit he found him in feeble 
health and suffering with acute pain in the left foot ; skin 
of the toes, black, cold and insensible ; ankle and instep 
swollen, and the ^^^Mnding tissues infiltrated. The 
foot had been poumced. The poultices were removed, 
the foot first washed with strong suds of castile soap, 
followed by another wash of strong solution of carbolic 
acid, and afterward enveloped in an ointment composed 
of vaseline and iodoform. The constitutional treatment 
followed was rare broiled beef, with but little other food, 
and a tablespoonful of old apple whiskey after each meal. 
Anodynes were prescribed, sufficient to relieve pain. 
Health and strength slowly improved, and, after a few 
weeks, the anodynes were withdrawn. In time, all the 
toes dropped off except the small one ; healthy granula- 
tions formed at the stumps, healing kindly. The foot is 
now perfectly sound, the health and strength good, and 
at present, after fifteen months of illness, the patient is 
enabled to walk a mile or two at a stretch without fatigue. 

In Newton and its vicinity I do not think the character 
of diseases has undergone any material change for some 
years. We are still subject to intermittent and remittent 
fevers, but rather less than for the two preceding years. 
Last year and the year before, at Baleville, along the line 
of the new railroad, nearly every family in the village 
suflFered more or less from fevers, and chills and fever, but 
for the past year I have heard but little about it. In our 
village (Newton), some attention has been given, for the 
past two years, to the sanitary laws, and I trust we have 
already been able to note the benefits arising therefrom. 



282 MEDICAL SOCIETY OF NEW JERSEY. 

To be a member of the Board of Health in a town of 
this size is not an enviable position. One has to contend 
against ignorance and prejudice, and the inhabitants need 
to be taught, persuaded and threatened into conformity 
with the requirements of the health laws. I think the 
milder course has been pretty generally pursued by our 
health officials, and we are getting on very well. 

L. D. MILLER, Reporter. 
Newton, N. J., May 21st, 1884. 



UNION COUNTY. 
To the Chairman of the Standing Committee^ &c. : 

From the almost total absence of information derived 
from the members of the profession in Union County, I 
have not the data from which to give a full report. From 
such information as I have received, I am convinced that 
the county has enjoyed an immunity during the past year 
from any decided epidemic influences. 

I hereby submit a few facts concerning the Muhlenberg 

Hospital, at Plainfield. 

M. B. LONG, Reporter, 

Plainfield, May 14th, 1884. 



Muhlenberg Hospital, in the City of Plainfield, 

New Jersey, 

Was incorporated May loth, 1877, under an Act of the Legislature 
providing for the erection and maintenance of hospitals, infirmaries, 
orphanages, asylums and other charitable institutions. The first 
meeting of the Board of Governors was held July 17th, 1877, at which 
time an organization was completed, and by-laws governing the 
Society were adopted. The corner-stone of the Hospital was laid 
May 31st, 1880, and opened for the reception of patients Nov., 1881. 



REPORTS OF DISTRICT SOCIETIES. 283 

The government of the Hospital is vested in a board of nineteen 
Governors, but the immediate control of the management is in the 
hands of a managing committe'e, consisting of five Governors, chosen 
each year, who are responsible to the Board for the general vvrorking 
of the Hospital, admitting patients, &c. The Medical Staff is divided 
into surgical and medical departments. Eight physicians constitute 
the present Staff — four in each department. A consulting physician 
and surgeon are also attached to the Staff. One physician and one 
surgeon serve at the Hospitalfor three months at a time, whose ser- 
vices are gratuitous. The Hospital building is constructed on a plan 
commonly known as a " Cottage Hospital." Has two wards, with 
accommodations for six patients in each, which can be increased, 
should necessity require. The working force consists of a Superin- 
tendent and nurse, with two hou>e servants. The Hospital is situated 
on the outskirts of the city, in a very favorable location, which was 
selected as being best adapted for the purpose, there being sufficient 
ground about the building to insure its being kept, to a certain extent, 
isolated. 

Total number of patients treated at the Hospital from 

Dec. I, 1881, to Jan. i, 1883 52 

From Jan. i, 1883, to May i, 1884 60 

Totals.... 112 

In addition to the work of the Hospital proper, a dispensary for the 
treatment of out-door patients has been carried on with marked 
success. 

Cost of building and furniture, about $6,700 

Estimated cost of maintenance per year 1,800 



WARREN COUNTY. 
To the Chairman of the Standing Committee^ &c, : 

Nothing seems to have transpired among the members 
of our County Society during the past year of sufficient 
importance to cause more than one or two of my brethren 
to send me a communication. 



284 MEDICAL SOCIETY OF NEW JERSEY. 

We have the honor of having two living Fellows in our 
county, and a number of others who are eligible to the 
same distinction by reason of long and honorable service 
in the profession. We have also a number of young and 
aspiring M. D/s who certainly are able to give us a mod- 
est and moderate report of their doings in our county. 
We have waited in vain, and the little we send has been 
obtained through many trials and tribulations. 

In the obituary notice of James Clark Fitch, M. D., of 
Hope, N. J., I must not forget the kindness of the vener- 
able Caleb Swayze, of the same town, who rendered me 
much assistance in obtaining valuable material. 

Dr. P. F. Hulshizer, of Stewartsville, sends a short 
communication, in which he gives an account of 
five cases of scarlatina, evidently spontaneous, occurring 
in two families living about one hundred yards apart. 
The disease manifested itself in the two families about 
the same time. No other cases far or near, nor had the 
children visited each other for many days. None of them 
had been from home for some weeks. Speaking of inter- 
mittent fever, he says : ** I have concluded the only sure 
success in treatment is in heroic doses — say from fifteen 
to twenty grains — of quinine, repeated every four hours 
until three doses are taken. In five or six days repeat 
the same dose in the same way, and again in the same 
length of time repeat, and so on four or five times. Of 
all the ways to take sulph. quiniae (and I speak from 
experience), the powder is the easiest, taken in any sour 
juice, as cherry juice, and drank with water.** 

I have nothing from any other member of our Society 
except verbal reports, which are not as satisfactory as 
written ones, especially as, I am sorry to say, I have a 
poor memory. A few years ago we had a system, in 
which blanks were sent out to each member of every 



REPORTS OF DISTRICT SOCIETIES. 285 

District Society in the State. It worked better than 
anything we have had before or since. 

In Phillipsburg and vicinity during the past year, we 
have had a very fatal type of acute inflammatory rheuma- 
tism, death, in several of the cases, resulting from car- 
ditis, pericarditis and endocarditis. The salicylates, I am 
inclined to think, are contra-indicated where there is the 
second attack of acute rheumatism. 

J. H. GRIFFITH, Reporter. 

Phillipsburg, N. J., May 14th, 1884. 



The Medical Society of New Jersey does not hold 
itself responsible for the sentiments expressed by the 
authors of papers ; nor for the reports of clinical cases 
furnished by the reporters of the District Societies. — 
Transactions, i8j6, page j8. 



CONTENTS. 






• m • — 

• PAGE. 

OFFICERS 4 

FELLOWS 5 

HONORARY MEMBERS 7 

MEMBERS OF DISTRICT SOCIETIES 9 

SUMMARY OF MEMBERS 20 

MINUTES 21 

APPENDIX TO THE MINUTES— 

Treasurer's Report 39 

REPORT OF Committee on Treasurer's Account 40 

Corresponding Secretary 41 

Committee on Honorary Members 42 

" Committee on Army Medical Museum and 

Library of Surgeon-General's Office 43 

" Committee on Lunacy 45 

" Delegate to the American Medical Associa- 
tion 49 

•' Delegate to the Medical Society of the 

State of Pennsylvania 52 

" Delegate to the Connecticut State Medical 

Society 52 

" Delegate to the Massachusetts Medical So- 
ciety 54 

PRESIDENT'S DISCOURSE 59 

ESSAYS— 

The Prevention and Treatment of Purulent Conjunc- 
tivitis, by Charles J. Kipp, M. D 95 

Seven Successful Cases of Ovariotomy, by E. J. Ill, M. D.. iii 

REPORTS OF STANDING COMMITTEE 133 

I N MEMORIAM 161 

OBITUARIES— 

B. Rush Bateman, M. D 163 

JoliN A. Rogers, M. D 165 

Lewis Mackey Osmun, M. D 166 

James Clark Fitch, M. D 168 

John Alexander Somerville, M. D 170 

Joseph C. Weatherby, M. D 172 

General John M. Cuyler, M. D 174 

Reports of District Societies— 

ATLANTIC COUNTY, Report by J. E. Sheppard, M. D 176 



288 CONTENTS. 

PAGE. 

HERGEN COUNTY, Report by J. M. Simpson, M. D i8o 

Thk Artificial Alimentation of Infants, by Milton 

Turnure, M. D 184 

Blood-Lktting, by Frederick Morris, M. D 185 

BURLINGTON COUNTY, Report by S. C. Thornton. M. D 186 

Muscular Hypertrophy of the Stomach, by Alexander 

Marcy, Jr., M. D T 190 

CAMDEN COUNTY, Report by John W. Snowden. M. D 192 

A Cask op Pleurisy Resulting in Pyothorax, by A. M. 

Mccray, M. D 197 

HoMCKPATiiic Remedies, by John R. Stevenson, M. D 199 

CAPE MAY COUNTY, Report by Virgil M. D. Marcy, M. D 208 

A Case of Internal Abscesses, by G. C. Carll, M. D 211 

A Case of Double Uterus, by Virgil M. D. Marcy, M. D. . 214 

A Case of Encephaloid Disease of the Omentum, by 

I. M. Downs, M. D .\ . . 215 

CUMBERLAND COUNTY, Report by J. Ingram. M. D 216 

ESSEX COUNTY, Report by Wm. J. Chandler, M. D 219 

Chorea, by J. Henry Clark, M. D 227 

A New Mode of Malarial Poisoning, by J. W. Stickler, 

M. 1) 229 

Annllar Disease of the Ear — A Sequel of Mumps, by 

T. R. Chambers, M. D 230 

The Fallacy of the Legal Tests of Insanity, by P. 

V. Hewlett, M. D 231 

GLOUCICSTER COUNTY, Report by Benjamin F. Buzby, M. D. 245 

Epidemic of Scarlet Fkver, by E. T. Oliphant, M. D 248 

HUDSON COUNTY, Report by G. F. Pitts, M. D 249 

HUNTERDON COUNTY. Report by C. W. Larison, M. D....... 252 

Case, by H. Shannon, M. D 255 

MERCER COUNTY. Report by H. M. Weeks, M. D 256 

MIDDLESEX COUNTY, Report by Frank M. Donohue. M. D. . . 259 

MONMOUTH COUNTY, Report by D. E. Roberts. M. D 262 

Cases, by Georgo T. Welch, M. D 266 

Bright's Disease, by Charles H.Thompson, M. D 268 

MORRIS COUNTY. Report by Stephen Pierson, M. D 271 

OCEAN C:OUNTY. Report by E. C. Disbrow, M. D 272 

PASSAK^ UOUNl Y. Report by Philander A. Harris. M. D 273 

SALEM COUN TY, Report by ClitY. \L Shenon. M. D 278 

SOMERSET COUNTY. Report by W. B. Ribble, M. D 280 

SUSSEX CX)UNTY, Report by L, D. Miller, M. D 280 

UNION COUNTY. Report by M. B. Long, M. D 282 

Muhi.enhkrg Hospital, Plainfiei.d, N. J., by M. B. Long, 

M, D 282 

WARREN COUNTY. Report by J. H. Grimth. M. D 283 



At the meeting of the American Medical Association 
held at Washington in May last, an Amendment to Regu- 
lation II was adopted, which provides that — 

Membership in the Association shall be obtainable 
by any member of a State or County Medical Society 
recognized by the Association, upon application endorsed 
by the President and Secretary of said Society ; and shall 
be retained so long as he shall remain in good standing 
in his local Society, and shall pay his annual dues to the 
Association. 

Applications for membership, in the manner specified 
above, accompanied with Five Dollars* tor annual dues, 
should be sent directly to the Treasurer, Dr. Richard J. 
DuNGLisoN, Lock Box 1274, Philadelphia, Pa.; on receipt 
of which the weekly Journal of the Association will be 
forwarded for one year to such member.